辛伐他汀、维生素E联用对冠心病患者氧化修饰低密度脂蛋白及血小板活化的影响

目的:通过辛伐他汀及其与维生素E联用治疗冠心病合并低高密度脂蛋白-胆固醇(HDL-C)血症患者,探讨HDL-C与氧化修饰低密度脂蛋白(Ox-LDL)及血小板活化的关系。方法:选择冠心病合并低HDL-C血症病人40例,分为辛伐他汀组及辛伐他汀与维生素E联合治疗组,比较治疗前后Ox-LDL、血栓素B₂(TXB₂)、血小板膜表面α-颗粒膜蛋白(GMP-140)水平的变化及与HDL-C的关系。结果:两组血浆HDL-C浓度均较治疗前明显升高,接近正常对照水平。联合治疗组血浆Ox-LDL、TXB₂浓度、GMP-140水平均较治疗前明显降低。辛伐他汀组上述3指标(不包含HDL-C)亦较治疗前明显降低。结论:在体内HDL-C亦能有效抑制LDL的氧化修饰,联合使用辛伐他汀与维生素E提高HDL-C,降低Ox-LDL浓度后,能有效抑制血小板活化。

The influence of oral simvastatin and vitamine-E on serum LDL oxidation and platelet activation in coronary artery disease patients

AIM: Using simvastatin and vitamine E (Vit-E) treatment to coronary artery disease (CAD) patients with low HDL, to investigate the relationship between Ox-LDL, platelet activation and HDL. METHODS: 40 CAD patients with low HDL were divided into two groups (A and B): A group oral simvastatin, B group oral simvastatin and Vit-E. The level of serum Ox-LDL, TXB 2 and GMP-140 were measured before and after treatment. The relationship between Ox-LDL, TXB 2, GMP-140 and HDL were analysed. RESULTS:The level of serum HDL was significantly increased in A and B group after treatment and attained normal level. The level of serum Ox-LDL, TXB 2 and GMP-140 were decreased significantly after simvastatin and Vit-E treatment and neared normal. CONCLUSIONS:This study confirmed that HDL can effectively refrain LDL oxidation. It also revealed that Vit-E and simvastatin treatment were more effectively refrained platelet activation by increasement of HDL and decreasement of Ox-LDL.