Kiortisis D N, Millionis H, Bairaktari E, Elisaf M S
Department of Internal Medicine, Medical School, University of Ioannina, Greece.
Eur J Clin Pharmacol. 2000 Dec;56(9-10):631-5. doi: 10.1007/s002280000213.
In patients with mixed lipid disorders, monotherapy may not effectively control all lipid abnormalities. We undertook this study to assess the efficacy of fenofibrate in combination with atorvastatin in patients with severe mixed dyslipidemia.
This was an 18-week, open-label study conducted in our lipid clinic. After a 6-week dietary baseline phase, patients received 200 mg/day micronised fenofibrate for 6 weeks. At the end of this period the subjects discontinued this treatment and received 40 mg/day atorvastatin for 6 weeks. Finally 200 mg/day of micronised fenofibrate was added to the statin therapy.
Administration of micronised fenofibrate reduced serum triglycerides (P < 0.01) and total cholesterol and low-density lipoprotein (LDL) cholesterol (P < 0.05 for both parameters), while it evoked a significant increase in serum high-density lipoprotein (HDL) cholesterol levels (P < 0.05). Atorvastatin monotherapy induced a more pronounced decrease of total and LDL cholesterol. However, plasma triglycerides, although significantly lower than baseline values (P < 0.05), were higher than the values observed during treatment with fenofibrate. Moreover, serum HDL cholesterol concentrations were higher during fibrate therapy than during the statin one. During the combination therapy, the decrease in triglycerides was greater than that observed with fenofibrate alone, while the decrease in LDL cholesterol was more pronounced than that observed with atorvastatin alone.
The combination of atorvastatin with micronised fenofibrate in patients with severe mixed dyslipidemia may have a favourable effect on some major coronary artery disease risk factors.
在混合性血脂异常患者中，单一疗法可能无法有效控制所有血脂异常情况。我们开展这项研究以评估非诺贝特联合阿托伐他汀对重度混合性血脂异常患者的疗效。
这是一项在我们血脂门诊进行的为期18周的开放标签研究。经过6周的饮食基线期后，患者接受每日200毫克微粒化非诺贝特治疗6周。在此阶段结束时，受试者停止该治疗，接受每日40毫克阿托伐他汀治疗6周。最后，在他汀类药物治疗基础上加用每日200毫克微粒化非诺贝特。
给予微粒化非诺贝特可降低血清甘油三酯（P < 0.01）以及总胆固醇和低密度脂蛋白（LDL）胆固醇（两个参数均P < 0.05），同时血清高密度脂蛋白（HDL）胆固醇水平显著升高（P < 0.05）。阿托伐他汀单一疗法使总胆固醇和LDL胆固醇下降更为明显。然而，血浆甘油三酯虽显著低于基线值（P < 0.05），但高于非诺贝特治疗期间观察到的值。此外，贝特类药物治疗期间血清HDL胆固醇浓度高于他汀类药物治疗期间。在联合治疗期间，甘油三酯的下降幅度大于单独使用非诺贝特时，而LDL胆固醇的下降幅度比单独使用阿托伐他汀时更为明显。
阿托伐他汀与微粒化非诺贝特联合应用于重度混合性血脂异常患者可能对一些主要的冠状动脉疾病危险因素产生有益影响。
