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Gipolipidemicheskie preparaty vliyayut na standartnye lipoproteiny, no kak izmenyayutsya pri lechenii drugie lipidy plazmy — ne izvestno. Cel'yu raboty bylo ocenit' dinamiku holesterina (HS), lipoproteinov vysokoj i nizkoj plotnosti (LVP i LNP), trigliceridov (TG) i sfingolipidov u pacientov s prezhdevremenno razvivshejsya ishemicheskoj bolezn'yu serdca, aterosklerozom i giperholisterinemiej na fone gipolipidemicheskoj terapii. V issledovanie vklyucheno 18 bol'nyh  (srednij vozrast 53 ± 6,7 goda): v 1-j gruppe 6 pacientov poluchili startovye dozy statinov; vo 2-yu gruppu voshli 6 pacientov, ne dostigshih na fone startovoj terapii statinami celevyh urovnej LNP i prinimavshih uvelichennye dozy statinov; 7 pacientov 3-j gruppy ne dostigli celevyh urovnej LNP na fone terapii maksimal'no perenosimymi dozami statinov i ezetimiba i poluchali alirokumab. Issledovanie urovnya sfingolipidov provodili metodom mass-spektrometrii. V 1-j gruppe otmecheno snizhenie urovnya ceramida Cer 14:1 (p = 0,046) i sfingomielinov SM 22:1, SM 22:0, SM 24:0 (p = 0,028). Urovni obshchego HS (OHS), HS LNP, HS LVP i TG  sushchestvenno ne izmenilis'. Vo 2-j gruppe otmecheno dostovernoe snizhenie urovnya OHC (p = 0,028), LNP (p = 0,043), sfingomielinov SM 18:1, SM 24:1 i SM 26:1, ceramida Cer 16:1 (p = 0,028). Cer 22:1 dostoverno uvelichilsya (p = 0,028). V 3-j gruppe OHS snizilsya na 36,2%, HS  LNP (p = 0,018) — na 60,1% ot iskhodnyh znachenij (ΔHS LNP = –2,67 ± 3,12), vyyavleno povyshenie urovnya ceramida Cer 22:1 (p = 0,028). Pokazano, chto snizhenie soderzhaniya sfingomielinov proiskhodit na fone terapii statinami i korreliruet so snizheniem urovnya HS LNP. Znachimoj dinamiki ceramidov i ceramidnogo riska na fone terapii statinami ne zaregistrirovano, odnako pri dobavlenii k terapii ingibitora PCSK9 proizoshlo umen'shenie sootnosheniya Cer 16:0/24:0.

Izmenenie koncentracii sfingolipidov v plazme krovi na fone gipolipidemicheskoj terapii u pacientov s rannim aterosklerozom