过氧化物酶体增殖物激活型受体α激动剂改善高甘油三酯血症患者冠状动脉血流速度储备功能的研究  

Research on improvement of coronary artery endothelial function by PPAR-α agonist in patients with hypertriglyceridemia

作　　者：王广[1] 何立芸[2] 于婕[2] 高霞[1] 苗莉[1] 王琛[3] 李卫虹[2] 安慧杰[3] 徐援[1] 

机构地区：[1]首都医科大学附属北京朝阳医院内分泌科,北京100020 [2]北京大学第三医院心内科 [3]北京大学第三医院内分泌科

出　　处：《中华临床医师杂志（电子版）》2012年第24期8020-8023,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金资助项目(30730042;30770873);国家重点研究基础研究发展计划973资助项目(2011CB503904)

摘　　要：目的探讨过氧化物酶体增殖物激活型受体α(PPAR-α)激动剂非诺贝特对高甘油三酯血症患者的冠状动脉血流速度储备功能(CFVR)的影响。方法选取58例高甘油三酯血症患者,分为非诺贝特治疗(200mg/d)组35例和对照组23例,随访12周,利用多普勒超声心动测定CFVR。结果与基线和对照组相比,非诺贝特治疗组CFVR明显高于基线水平(3.14±0.36vs.2.80±0.58,P<0.01)和对照组(3.14±0.36vs.2.79±0.65,P<0.05),而对照组和基线水平无统计学差异。非诺贝特治疗后显著降低患者血浆单核细胞趋化蛋白(MCP-1)的水平。非诺贝特治疗组血浆同型半胱氨酸(Hcy)水平显著高于基线水平和对照组。结论 PPAR-α激动剂非诺贝特可以显著改善高甘油三酯血症患者CFVR功能,并能显著降低血浆炎症因子的表达,进而发挥血管内皮保护效应,但此效应可能被其升高的血浆Hcy水平的副作用所削弱。Objective We investigated the effect of the peroxisome proliferator-activated receptor-α(PPAR-α)agonist on coronary artery endothelial function in patients with hypertriglyceridemia.Methods Fifty eight patients with hypertriglyceridemia were divided into 2 groups:control group(no treatment;n=23)and fenofibrate treatment group(n=35),200 mg/d,for 12 weeks.The patients had undergone rest and adenosine treatment to induce hyperemia for quantification of coronary flow velocity reserve(CFVR)by noninvasive Doppler echocardiography before treatment and after 12-week follow-up respectively.Results CFVR was significantly improved with fenofibrate treatment as compared with baseline level and control group(3.14±0.36 vs.2.80±0.58 and 2.79±0.65,P<0.01 and 0.05,respectively),with no difference between baseline levels and untreated controls.In addition,at 12 weeks,plasma level of homocysteine was significantly increased with fenofibrate treatment as compared with at baseline and control group.Plasma level of MCP-1 was significantly reduced from baseline to 12 weeks after fenofibrate treatment.Conclusions Treatment with PPAR-α agonist fenofibrate significantly improved CFVR in patients with hypertriglyceridemia.This endothelial protective effect may be reduced in part by the side effect of increasing homocysteine.

关 键 词：过氧化物酶体增殖物激活受体 内皮功能 冠状动脉血流储备 

分 类 号：R589.2[医药卫生—内分泌]