Tokoo M, Oguchi H, Terashima M, Tokunaga S, Miyasaka M, Hora K, Higuchi M, Yoshie T, Furuta S
2nd Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Nihon Jinzo Gakkai Shi. 1992 Apr;34(4):397-403.
The nephrotic syndrome is often accompanied by hyperlipidemia associated with an increased risk of accelerated atherosclerosis. The present study was undertaken to evaluate the effects of pravastatin, a novel competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, on the serum lipids and apolipoproteins in patients with this syndrome and marked hyperlipidemia. Eleven adult patients received 10 mg of pravastatin twice daily for 4 to 8 weeks. The total serum cholesterol decreased from 426 +/- 44 to 309 +/- 18 mg/dl (-27.4%, mean +/- S.E.; p less than 0.01) following administration of pravastatin. The serum triglyceride decreased from 332 +/- 122 to 229 +/- 50 mg/dl (-30.9%), although this change was not significant. Despite the fact that the HDL cholesterol level was barely changed (51 +/- 7 to 51 +/- 6 mg/dl), the LDL cholesterol fell from 313 +/- 30 to 211 +/- 16 mg/dl (-32.5%; p less than 0.005), and the LDL to HDL cholesterol ratio fell from 7.57 +/- 1.59 to 4.94 +/- 0.88 (-34.8%; p less than 0.05). These changes caused the atherogenic index to decline from 9.6 +/- 2.4 to 6.1 +/- 1.2 (-36.5%; p less than 0.05). No significant alterations could be found among apolipoproteins A-1, A-2, B, C-2, C-3, and E. During the present study period, pravastatin was well tolerated and did not affect the serum protein, albumin, serum urea nitrogen, creatinine levels, or urine protein excretion. Also, there were no serious adverse effects. Pravastatin appears to be effective for treating patients with hyperlipidemia of the nephrotic syndrome.
肾病综合征常伴有高脂血症，这会增加加速动脉粥样硬化的风险。本研究旨在评估新型3-羟基-3-甲基戊二酰辅酶A还原酶竞争性抑制剂普伐他汀对该综合征伴显著高脂血症患者血脂和载脂蛋白的影响。11名成年患者每日两次服用10毫克普伐他汀，持续4至8周。服用普伐他汀后，血清总胆固醇从426±44降至309±18毫克/分升（-27.4%，均值±标准误；p<0.01）。血清甘油三酯从332±122降至229±50毫克/分升（-30.9%），尽管这一变化不显著。尽管高密度脂蛋白胆固醇水平几乎未变（从51±7降至51±6毫克/分升），但低密度脂蛋白胆固醇从313±30降至211±16毫克/分升（-32.5%；p<0.005），低密度脂蛋白与高密度脂蛋白胆固醇比值从7.57±1.59降至4.94±0.88（-34.8%；p<0.05）。这些变化使致动脉粥样化指数从9.6±2.4降至6.1±1.2（-36.5%；p<0.05）。载脂蛋白A-1、A-2、B、C-2、C-3和E之间未发现显著变化。在本研究期间，普伐他汀耐受性良好，不影响血清蛋白、白蛋白、血清尿素氮、肌酐水平或尿蛋白排泄。此外，未出现严重不良反应。普伐他汀似乎对治疗肾病综合征高脂血症患者有效。
