Bairaktari E T, Tzallas C S, Tsimihodimos V K, Liberopoulos E N, Miltiadous G A, Elisaf M S
Biochemistry Laboratory, University Hospital, Ioannina, Greece.
J Cardiovasc Risk. 1999 Apr;6(2):113-6. doi: 10.1177/204748739900600208.
To evaluate and compare the influences of micronized fenofibrate and atorvastatin on serum lipid profile, including lipoprotein(a) levels, and on fibrinogen levels in a large group of patients with primary mixed hyperlipidemia (serum total and low-density lipoprotein cholesterol levels > 240 and 160 mg/dl, respectively, and serum triglyceride level > 200 mg/dl).
This was a 16-week, open-label, parallel-design study conducted in our lipid clinic. After a 6-week dietary baseline phase, we implemented a treatment phase, during which patients received 10 mg/day atorvastatin (n = 45) or 200 mg/day micronized fenofibrate (n = 46) for 16 weeks. Patients were assigned to one of the drugs in sequential orders. Serum lipid profiles, including levels of lipoprotein(a) and fibrinogen, as well as muscle and liver enzymes, were measured during screening, and during weeks -4, -2, 0, 8, and 16 of the treatment period.
Atorvastatin was more effective than was micronized fenofibrate at lowering levels of total and low-density lipoprotein cholesterol, whereas fenofibrate was more effective at lowering levels of triglycerides, and raising levels of high-density lipoprotein cholesterol and apolipoprotein A1. However, micronized fenofibrate could significantly decrease plasma fibrinogen levels, whereas atorvastatin evoked a small increase.
Both atorvastatin in small doses and micronized fenofibrate are effective for improving serum lipid profiles of patients with mixed hyperlipidemia. However, there are considerable differences between the two drugs concerning their influences on plasma fibrinogen levels.
评估并比较微粒化非诺贝特和阿托伐他汀对一大组原发性混合性高脂血症患者（血清总胆固醇和低密度脂蛋白胆固醇水平分别>240和160mg/dl，血清甘油三酯水平>200mg/dl）血脂谱（包括脂蛋白(a)水平）及纤维蛋白原水平的影响。
这是一项在我们血脂门诊进行的为期16周的开放标签、平行设计研究。在为期6周的饮食基线期后，我们进入治疗阶段，在此期间患者接受10mg/天阿托伐他汀（n = 45）或200mg/天微粒化非诺贝特（n = 46）治疗16周。患者按顺序被分配到其中一种药物组。在筛查时以及治疗期的第-4、-2、0、8和16周测量血脂谱，包括脂蛋白(a)和纤维蛋白原水平，以及肌肉和肝脏酶。
阿托伐他汀在降低总胆固醇和低密度脂蛋白胆固醇水平方面比微粒化非诺贝特更有效，而非诺贝特在降低甘油三酯水平、提高高密度脂蛋白胆固醇和载脂蛋白A1水平方面更有效。然而，微粒化非诺贝特可显著降低血浆纤维蛋白原水平，而阿托伐他汀则引起小幅升高。
小剂量阿托伐他汀和微粒化非诺贝特对改善混合性高脂血症患者的血脂谱均有效。然而，这两种药物在对血浆纤维蛋白原水平的影响方面存在相当大的差异。
