匹伐他汀对合并脂代谢异常的稳定型冠心病患者HDL-C水平及功能的影响  

Effect of pitavastatin on levels and functions of HDL-C in patients with stable coronary artery disease and dyslipidemia

作　　者：王会娟[1] 王继红[1] 赵兴山[1] 刘巍 WANG Hui-juan;WANG Ji-hong;ZHAO Xing-shan;LIU Wei(Department of Cardiology, Beijing Jishuitan Hospital, Beijing 100096, China)

机构地区：[1]北京积水潭医院心内科,北京100096

出　　处：《基础医学与临床》2022年第3期467-471,共5页Basic and Clinical Medicine

基　　金：中国循环杂志“京心鹤护”科研基金(CCJJXHH-2)。

摘　　要：目的研究匹伐他汀对合并脂代谢异常的稳定型冠心病患者高密度脂蛋白胆固醇(HDL-C)水平及其介导的胆固醇外流与抗氧化功能的影响。方法选取合并脂代谢异常的稳定型冠心病患者60例,随机分为匹伐他汀(2~4 mg/d)和阿托伐他汀(10~20 mg/d)各30例并治疗6个月。分别于治疗前及治疗后抽取外周静脉血,湿化学法测定血脂水平,以急性单核细胞白血病细胞系(THP-1)细胞测定3H-胆固醇标记的胆固醇外流率,并测定对氧磷酶1(PON-1)活性水平。结果他汀治疗6个月后,匹伐他汀组患者的HDL-C水平升高了9.0%,而阿托伐他汀组仅有轻度升高(1.8%)(P<0.01)。匹伐他汀治疗后HDL介导的胆固醇外流率显著升高[(12.83%±1.64%)比(17.67%±1.71%)](P<0.001)。两组患者治疗后PON-1酶活性水平均显著升高,其中匹伐他汀组,对氧磷酶和芳基酯酶活性分别增加了21%和18%(P<0.001);阿托伐他汀组对氧磷酶和芳基酯酶活性水平分别增加了24%和17%(P<0.001)。结论匹伐他汀在升高HDL-C水平的同时,使HDL-C介导的胆固醇外流与抗氧化功能均得到改善。Objective To evaluate the effect of pitavastatin on high-density lipoprotein cholesterol(HDL-C)level and cholesterol efflux and antioxidative properties of HDL in patients with dyslipidemia and stable coronary disease.Methods The study population included 60 patients with stable coronary disease and dyslipidemia.They were randomly allocated to treatment by pitavastatin 2-4 mg per day or atorvastatin 10-20 mg per day and followed up for six months.The cholesterol efflux and activities of antioxidative enzymes paraoxonase-1(PON-1)were evaluated before and after statins treatment.Results The effect of the 6-month treatment with pitavastatin on serum HDL-C level was significantly greater than that of atorvastatin(%change:pitavastatin 9.0%vs atorvastatin 1.8%,P<0.01).HDL induced cholesterol efflux increased significantly after the 6-month treatment with pitavastatin while it not was affected by atorvastatin treatment.However,HDL-associated PON-1 in both pitavastatin group and atovastatin groupall increased.The activity of PON-1 increased by 21%with pitavastatin and 24%with atorvastatin,while the activity of arylesterase increased by 18%with pitavastatin and 17%with atorvastatin(P<0.001).ConclusionsPitavastatin elevates the HDL-C level,enhances the cholesterol efflux and antioxidative effect of HDL.Therefore,pitavastatin increases the amount of functional HDL without attenuating HDL quality.

关 键 词：他汀 高密度脂蛋白胆固醇 胆固醇外流 对氧磷酶1 

分 类 号：R587.1[医药卫生—内分泌]