目的研究多廿烷醇在老年心血管疾病患者中调脂作用外的多效性作用。方法入选老年血脂异常患者共294例，随机将入选患者分4组，多廿烷醇20 mg组（A组，n＝64）、多廿烷醇10 mg组（B组，n＝72）、阿托伐他汀20 mg组（C组，n＝91）、多廿烷醇10 mg＋阿托伐他汀20 mg组（D组，n＝62）。所有患者分别于试验开始前、试验第12周、24周、52周时，测定其血小板计数、血小板聚集率、循环内皮细胞（ CECs）计数、超敏C反应蛋白（ hs-CRP）、颈动脉内膜中层厚度（ IMT）等。结果 A组治疗后二磷酸腺苷（ ADP）诱导的血小板聚集率较治疗前有较明显降低[（48．79±20．29）％比（40．37±23．56）％]，差异有统计学意义（P＜0．05），但花生四烯酸（AA）诱导的血小板聚集率差异无统计学意义。 B组、C组和D组的AA 及ADP诱导的血小板聚集率均差异无统计学意义。各组CECs、hs-CRP、同型半胱氨酸治疗后均较治疗前降低，差异有统计学意义（P＜0．05），但颈动脉IMT在各组治疗前后均差异无统计学意义。结论多廿烷醇除可调节血脂水平外，还有一定的改善内皮细胞功能及抗动脉粥样硬化作用。%Objective To comparatively observe Policosanol’ s multi effects beyond lipid lowering in the eld-erlypatientswithcardiovasculardiseases.Methods 294elderlypatientswithdyslipidemiawereincluded.Allpa-tients were randomly divided into four groups:policosanol 20 mg group ( group A,n=64); Policosanol 10mg group (group B,n=72);atorvastatin 20mg group (group C,n=91);policosanol 10mg +atorvastatin 20mg group(group D,n=62).The following indexes were observed at 0d,12th week,24th week and 52th week: platelet counts,platelet aggregation rates,CECs,and carotid artery intima-media thickness.Results ADP induced platelet aggregation rate was decreased significantly in group A when compared with the baseline [(48.79 ±20.29)% vs.(40.37 ± 23.56)%],but AA induced platelet aggregation rate was not.Both AA and ADP induced Platelet aggregation rates had no significant changes in other groups.CECs,hs-CRP and Hcy levels were all decreased significantly at 52th week after treatment in each group.There was no statistical change of IMT in each group after treatment.Conclusions Besides lipid modulating effects,policosanol also had other effects such as improving endothelial functions and preventing pro-gression of atherosclerosis.
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