Stein E A, Heimann K W
S Afr Med J. 1975 Jul 19;49(31):1252-6.
Fifty-seven patients, mean age 26 years, suffering from familial hyperbetalipoproteinaemia (Fredrickson type lla and llb), were treated on a low cholesterol, modified polyunsaturated fat diet for a period of 6-12 weeks prior to the introduction of drug therapy. No significant reduction in the serum levels of total cholesterol, low density lipoprotein (LDL) cholesterol or triglyceride was found. Fifty patients were then treated with colestipol for 6 weeks; total and LDL cholesterol decreased by 23%, but triglyceride levels were unaffected. During the following 6 weeks, placebo was administered, and total and LDL cholesterol returned to pretreatment levels. The patients were then randomly allocated into two groups of 16. The first group continued with clofibrate therapy, while the second group received cholestyramine. In the clofibrate group a reduction in total and LDL cholesterol of the order of 17% was noted, similar to cholestethat achieved in this group on colestipol. Triglyceride levels were 15% lower on clofibrate therapy than on colestipol. In the cholestyramine group, there was a 25% decrease in total and LDL cholesterol, compared with pretreatment levels. This reduction was similar to that found when colestipol was administered. Triglyceride values were significantly raised during cholestyramine therapy. Thirteen patients were then subjected to a 6-week period of combination therapy, either clofibrate or colestipol, or clofibrate and cholestyramine. Total and LDL cholesterol were reduced by 32% on combination therapy compared with 18% on colestipol and 23% on either clofibrate or cholestyramine alone. Furthermore, on combined therapy, triglyceride concentrations fell by 20% when compared with the levels found when colestipol, clofibrate or cholestyramine were administered on their own.
57名平均年龄为26岁、患有家族性高β脂蛋白血症（弗雷德里克森IIa型和IIb型）的患者，在开始药物治疗前，先接受低胆固醇、改良多不饱和脂肪饮食治疗6至12周。结果发现，总胆固醇、低密度脂蛋白（LDL）胆固醇或甘油三酯的血清水平均未显著降低。随后，50名患者接受考来替泊治疗6周；总胆固醇和LDL胆固醇下降了23%，但甘油三酯水平未受影响。在接下来的6周内，给予安慰剂，总胆固醇和LDL胆固醇恢复到治疗前水平。然后，患者被随机分为两组，每组16人。第一组继续使用氯贝丁酯治疗，而第二组接受考来烯胺治疗。在氯贝丁酯组中，总胆固醇和LDL胆固醇降低了约17%，与该组使用考来替泊时的降幅相似。氯贝丁酯治疗时的甘油三酯水平比考来替泊治疗时低15%。在考来烯胺组中，总胆固醇和LDL胆固醇与治疗前水平相比下降了25%。这一降幅与使用考来替泊时相似。考来烯胺治疗期间甘油三酯值显著升高。然后，13名患者接受为期6周的联合治疗，联合使用氯贝丁酯或考来替泊，或氯贝丁酯和考来烯胺。与单独使用考来替泊时18%的降幅以及单独使用氯贝丁酯或考来烯胺时23%的降幅相比，联合治疗使总胆固醇和LDL胆固醇降低了32%。此外，与单独使用考来替泊、氯贝丁酯或考来烯胺时的水平相比，联合治疗时甘油三酯浓度下降了20%。
