Okubo M, Nakamura M, Horii A, Kamata K, Takeuchi Y, Tsukamoto Y, Kobayashi N, Sato K, Endo T
Department of Medicine, Sano Kohsei Hospital, Tochigi, Japan.
Kidney Int Suppl. 1999 Jul;71:S229-30. doi: 10.1046/j.1523-1755.1999.07160.x.
Hypercholesterolemia is a well-known complication in kidney transplant recipients, although its pathogenesis may be multifactorial. The therapeutic effect of probucol on post-transplant hypercholesterolemia was prospectively evaluated.
Twelve hypercholesterolemic kidney transplant patients with serum total cholesterol > or = 250 mg/dl without diabetes mellitus or hypoproteinemia were prospectively treated with probucol (250 mg, bid, for three months). Before initiating and at the end of treatment, blood was drawn after at least a 12-hour fast to measure lipids in serum and lipoprotein fractions, apoproteins (apo), lipoprotein fractions, lethicin cholesterol acyl transferase (LCAT), free fatty acids (FFAs), and cholesterol ester. The lipid profiles of 17 healthy subjects were also examined.
After treatment with probucol, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and apo AI were significantly decreased, whereas cholesterol ester increased significantly.
Post-transplant hypercholesterolemia is featured with abnormalities in very low-density lipoprotein (VLDL) metabolism. Although HDL cholesterol decreased, probucol might have acted as an antiatherogenic by modulating HDL metabolism and stimulating reverse transfer of cholesterol from peripheral tissue.
高胆固醇血症是肾移植受者中一种众所周知的并发症，尽管其发病机制可能是多因素的。对丙丁酚治疗移植后高胆固醇血症的疗效进行了前瞻性评估。
12例血清总胆固醇≥250mg/dl且无糖尿病或低蛋白血症的高胆固醇血症肾移植患者接受丙丁酚治疗（250mg，每日两次，共三个月）。在开始治疗前和治疗结束时，至少禁食12小时后采血，以测定血清和脂蛋白组分中的脂质、载脂蛋白（apo）、脂蛋白组分、卵磷脂胆固醇酰基转移酶（LCAT）、游离脂肪酸（FFA）和胆固醇酯。还检查了17名健康受试者的血脂谱。
用丙丁酚治疗后，血清总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇和apo AI显著降低，而胆固醇酯显著增加。
移植后高胆固醇血症的特征是极低密度脂蛋白（VLDL）代谢异常。尽管HDL胆固醇降低，但丙丁酚可能通过调节HDL代谢和刺激胆固醇从外周组织的逆向转运而起到抗动脉粥样硬化作用。
