短期低剂量阿托伐他汀对低密度脂蛋白和高密度脂蛋白亚组分的影响  

Impact of Short-term Low-dose Atorvastatin on Low-density Lipoprotein and High-density Lipoprotein Subfraction Phenotype

作　　者：姚雨宏 徐瑞霞[1] 马春艳 郭远林[1] 李小林[1] 李莎[1] 李建军[1] YAO Yu-hong;XU Rui-xia;MA Chun-yan;GUO Yuan-lin;LI Xiao-lin;LI Sha;LI Jian-jun.(Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, State Key Laboratoty of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.)

机构地区：[1]北京协和医学院国家心血管病中心中国医学科学院阜外医院血脂异常与心血管病诊治中心,北京市100037

出　　处：《中国分子心脏病学杂志》2018年第1期2348-2351,共4页Molecular Cardiology of China

基　　金：首都卫生发展科研专项项目(2016-1-4035);北京协和医学院协和青年基金项目(3332016018;3332016023);国家自然科学基金资助项目(81100118)

摘　　要：目的研究低剂量阿托伐他汀对动脉粥样硬化患者高密度脂蛋白(HDL)和低密度脂蛋白(LDL)亚组分的影响。方法入选37例动脉粥样硬化患者,随机分为两组:阿托伐他汀10 mg治疗组(n=17例)和阿托伐他汀20mg治疗组(n=20),分别给予10 mg/d和20 mg/d阿托伐他汀治疗8周。另入选15名健康受试者作为对照组。Lipoprint脂蛋白分类检测仪对HDL和LDL颗粒进行分类。治疗8周后比较三组治疗前后血脂指标、HDL和LDL颗粒的变化,分析10 mg/d阿托伐他汀和20mg/d阿托伐他汀治疗对LDL和HDL颗粒的影响。结果动脉粥样硬化患者经阿托伐他汀(10 mg/d和20 mg/d)治疗8周后,血浆LDL-C浓度、LDL各亚组分胆固醇浓度及百分比均显著降低。动脉粥样硬化患者经20mg/d的阿托伐他汀治疗8周后,大颗粒HDL-C浓度及百分比显著升高,小颗粒HDL-C浓度及百分比显著降低。结论低剂量阿托伐他汀短期治疗即可显著改善LDL和HDL的亚组分分布,使其向动脉粥样硬化逆转的有益表型转变。Objective To investigate the short-term impact of low dose atorvastatin on HDL and LDL subfractions in humans. MethodsThirty-seven patients with atherosclerosis were randomized to be treated with atorvastatin 10 mg/d（n = 17） or 20 mg/d（n = 20） for 8 weeks. Meanwhile, 15 healthy subjects without therapy were taken to control group. The lipid profile and lipoprotein subfractions were determined using the Lipoprint system at baseline and at 8 weeks. Results atorvastatin treatment（10 and 20 mg/d） for 8 weeks significantly decreased LDL-C levels and reduced the cholesterol concentration of all LDL subfractions, which was accompanied by an increase of the mean LDL particle size. Although 10 mg/d atorvastatin treatment for 8 weeks had no impact on the HDL subfraction, 20 mg/day atorvastatin for 8 weeks significantly increased the cholesterol concentration of large HDL particles and decreased the cholesterol concentration of small HDL particles without changing serum HDL-C levels in patients with atherosclerosis. Therefore, the results suggested that 20 mg/day atorvastatin treatment for 8 weeks may result in a favourable modification of the HDL subfraction phenotype in addition to its effects on the cholesterol concentration of all LDL subfractions and mean LDL particle size. Conclusions The short-term impact of low-dose atorvastatin can change HDL and LDL subfractions in humans.

关 键 词：动脉粥样硬化 阿托伐他汀 高密度脂蛋白亚组分 低密度脂蛋白颗粒大小 低密度脂蛋白亚组分 

分 类 号：R543.5[医药卫生—心血管疾病]