Mertz D P, Suermann J
Med Klin. 1978 Jun 9;73(23):867-73.
14 previously untreated patients with hyperlipoproteinemia type IIa according to Fredrickson underwent a controlled clinical trial. The study was designed to clarify the effects of clofibrate on the bloodlipids. All patients were willing to cooperate. After leaving their usual dietary habits all of them were given for seven to ten days a "prudent" diet. This diet was rich in vitamins; it had a low caloric-content. 20% of the calories consisted of proteins, 35% of carbohydrates (sweets were omitted) and about 45% of fats with a PS-factor of about 2.2. After the initial dietary treatment all patients were given twice daily for 14 days 500 mg clofibrate. During the use of the "prudent" diet the serum-cholesterol-levels decreased in average with 14.8%. Compared to the values at the beginning of the trial the difference was statistically highly significant. The average-values of triglycerides, phosphatides and the relative percentage of HDL, LDL and VLDL remained unchanged. After the patients received clofibrate there was an additional decrease of the serum-cholesterol-values of 14.8%. The total decrease of the cholesterol-levels compared to the initial values amounted to 27.4%. Furthermore, there was a reduction of the phosphatids in the serum of 14.1% compared to the initial value and of 9.9% compared to the value after dietary treatment alone. Under the combined effects of a "prudent" diet with clofibrate the HDL increased significantly. It can be assumed that clofibrate reduces the serum-cholesterol-levels in cases of hyperlipoproteinemia by decreasing the LDL-fraction, which is rich in cholesterol, and by increasing the HDL-fraction.
14名根据弗雷德里克森分类法诊断为IIa型高脂蛋白血症且未经治疗的患者参与了一项对照临床试验。该研究旨在阐明氯贝丁酯对血脂的影响。所有患者均愿意合作。在摒弃其惯常饮食习惯后,所有患者均接受了7至10天的“谨慎”饮食。这种饮食富含维生素,热量低。20%的热量由蛋白质组成,35%由碳水化合物组成(不含甜食),约45%由脂肪组成,多不饱和脂肪酸与饱和脂肪酸的比例约为2.2。初始饮食治疗后,所有患者每天服用两次500毫克氯贝丁酯,持续14天。在采用“谨慎”饮食期间,血清胆固醇水平平均下降了14.8%。与试验开始时的值相比,差异具有高度统计学意义。甘油三酯、磷脂以及高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和极低密度脂蛋白(VLDL)的相对百分比的平均值保持不变。患者服用氯贝丁酯后,血清胆固醇值又额外下降了14.8%。与初始值相比,胆固醇水平的总下降幅度达27.4%。此外,与初始值相比,血清中磷脂减少了14.1%,与仅进行饮食治疗后的数值相比减少了9.9%。在“谨慎”饮食与氯贝丁酯的联合作用下,高密度脂蛋白显著增加。可以推测,氯贝丁酯通过降低富含胆固醇的低密度脂蛋白部分,并增加高密度脂蛋白部分,从而降低高脂蛋白血症患者的血清胆固醇水平。