n-3 Fatty acids and the prevention of coronary atherosclerosis
n-3 Fatty acids and the prevention of coronary atherosclerosis
复制标题
DOI：
10.1093/ajcn/71.1.224s
复制
发表时间：
2000-01-01
影响因子：
7.1
通讯作者：
von Schacky, C
中科院分区：
文献类型：
--
作者：
von Schacky, C
流行病学研究表明，食用鱼类或其他饮食来源的n-3脂肪酸与心血管事件呈负相关。饮食中n-3脂肪酸对参与动脉粥样硬化发病的因素的有利影响的许多作用机制已被描述。在狗、猪和非人类灵长类动物身上的研究一直表明，在各种血管闭塞性疾病模型中都有有益的效果。目前发表的研究并未表明饮食中的n-3脂肪酸可预防经皮冠状动脉成形术后的再狭窄或诱导冠状动脉粥样硬化的消退。然而，在最近的一项研究中，每天摄入4g鱼油浓缩物可以在1年后减少主动脉-冠状动脉静脉搭桥的闭塞。在饮食和再梗塞试验中，在建议每周至少食用两次n-3富含脂肪酸的脂肪鱼后，首次心肌梗死幸存者的2-y总死亡率降低了29%(《柳叶刀》1989；2：757-61)。当将n-3脂肪酸整合到类似传统地中海饮食的饮食中时，首次心肌梗死后5年的心血管死亡率降低了70%(《柳叶刀》1994；343：1454-9)。初步研究表明，心脏移植患者可能是一个有趣的研究重点。目前，富含n-3脂肪酸的食物被认为对心肌梗死后的二级预防有益。需要以发病率和死亡率等为终点的大规模临床研究，以更准确地确定n-3脂肪酸在冠状动脉粥样硬化一级和二级预防中的作用。
Epidemiologic studies have shown an inverse correlation between consumption of fish or other sources of dietary n-3 fatty acids and cardiovascular events. Numerous mechanisms of action for the favorable effect of dietary n-3 fatty acids on factors implicated in the pathogenesis of atherosclerosis have been described. Studies in dogs, swine, and nonhuman primates have consistently shown beneficial effects in various models of vasoocclusive diseases. Studies published currently do not indicate that dietary n-3 fatty acids prevent restenosis after percutaneous coronary angioplasty or induce regression of coronary atherosclerosis. However, in a recent study, occlusion of aortocoronary venous bypass grafts was reduced after 1 y by daily ingestion of 4 g fish-oil concentrate. In the Diet and Reinfarction Trial, 2-y overall mortality was reduced by 29% in survivors of a first myocardial infarction after consumption of n-3 fatty acid-rich fatty fish at least twice a week had been advised (Lancet 1989;2:757-61). When n-3 fatty acids were integrated into a diet resembling a traditional Mediterranean diet, 5-y cardiovascular mortality after a first myocardial infarction was reduced by 70% (Lancet 1994; 343:1454-9). Preliminary studies indicate that cardiac transplant patients could be an interesting focus of investigation. Currently, food sources rich in n-3 fatty acids are thought to be beneficial in secondary prophylaxis after a myocardial infarction. Large-scale clinical studies with endpoints such as morbidity and mortality are needed to more precisely define the role of n-3 fatty acids in primary and secondary prophylaxis of coronary atherosclerosis.