小剂量辛伐他汀对老年高脂血症疗效和脂质过氧化的影响

Effect of Small Dose Simvastatin on Lipid and Lipid Peroxidation in Elderly Patients with Hyperlipidemia

为研究小剂量辛伐他汀对血脂和脂质过氧化的影响，对62例老年高脂血症患者采用辛伐他汀治疗12周后，测定其血清脂质、载脂蛋白、丙二醛、超氧化物歧化酶和硝酸盐的含量。结果发现，血清总胆固醇、低密度脂蛋白胆固醇和载脂蛋白B水平较治疗前显著降低（P＜0．001），甘油三酯水平在治疗后4和8周末显著降低（P＜0．05）；丙二醛水平较用药前明显降低（P＜0．001），超氧化物歧化酶活性明显升高（P＜0．001）。而硝酸盐在治疗前后无明显变化。辛伐他汀治疗前超氧化物岐化酶活性与低密度脂蛋白胆固醇、甘油三酯及总胆固醇水平呈显著负相关，治疗12周末丙二醛水平降低与低密度脂蛋白胆固醇和载脂蛋白B水平呈显著正相关。由此提示，辛伐他汀可改善体内脂质代谢异常，减轻脂质过氧化状态，有利于冠心病的一致和二级预防。

Aim: This study was to evaluate the effect of small dose simvastatin on lipid and lipid peroxidation in elderly patients with hyperlipidemia. Methods: Simvastatin (5 mg/day) was administered to 62 elderly patients with hyperlipidemia for 12weeks.Results: Simvastatin caused a significant decrease in serum levels of cholesterol, low density lipoprotein cholesterol(LDLC )and apolipoprotein B (P<0. 001 )at the end of 4, 8 and 12 week therapy. Although triglyceride(TG) level was also significantly reduced at the end of 4 and 8 weeks (P<0. 05), the reduction was not statistically significant at end of 12 weeks.Meanwhile, superoxide dismutase (SOD) rised and malondialdehyde (MDA) fell with simvastatin therapy (P<0.001). Although level of NO-3, a nitric oxide metabolic product, eIevated with the treatment, the change wes not statistically significant. Furthermore, SOD activity was negatively correlated with LDLC, TG and total cholesterol (TC) levels at baseline and also MDA level was positively associated with LDLC and apolipoprotein B levels at the end of treatment (P<0.05) on linear regression analysis.Conclusion: Simvastatin can significantly improve lipid metabolism and diminish lipld peroxidation in the elderly patients with hyperlipidemia.