Sucić M
Lijec Vjesn. 1989 Mar;111(3):93-7.
Hyperlipoproteinaemia may represent a high risk factor in the pathogenesis of atherosclerosis, especially for the coronary heart disease. This metabolic disorder should therefore be treated. Strict diet is the basis of the treatment. In case the lipoprotein level does not normalize by means of diet, medicamentous therapy ought to be applied in addition. A total of 269 individuals suffering from hyperlipoproteinaemia have been treated in this study. According to Fredrickson there were 35 with Type IIa, 134 with Type IIb, 32 with Type IV and 68 with Type V. All of them had been previously treated with diet for at least three months. Afterwards, they were treated with fenofibrate (Katalip) in a dosage of 100 mg, 2 capsules in the morning and 1 in the evening. Biochemical parameters were checked a month after start of therapy. Cholesterol (-20%, -17%, -114%, -224%), triglycerides (-31%, -37%, -47%, -704), LDL cholesterol (-23%, -19%, -11% no significant, -31%), VLDL cholesterol (-25%, -29%, -32%, -59%), atherosclerosis index (-27%, -28%, -28%, -55%), urea (-5% no significant, -21%, -22%, -28%), gamma GT (-23%, -25%, -15% no significant, -39%) of patients with Type IIa, IIb, IV and V have decreased significantly (P less than 0.05), whereas the value of HDL cholesterol increased (0% no significant, +20%, +12%, +29%). No statistically significant changes during the therapy were observed in alkaline phosphatase (-8%, -9%, -11%, -10%), SGOT (-3%, -8%, +5%, -15%), SGPT (-22%, +4%, -18%, -15%) and glucose (-17% significant, -5%, -7%, -10%). Fenofibrate decreases the risk of the development of atherosclerosis by lowering lipoproteins and uric acid level.
高脂蛋白血症可能是动脉粥样硬化发病机制中的一个高危因素,尤其是对冠心病而言。因此,这种代谢紊乱应该得到治疗。严格的饮食是治疗的基础。如果通过饮食脂蛋白水平不能恢复正常,则应加用药物治疗。本研究共治疗了269例高脂蛋白血症患者。根据弗雷德里克森分类法,其中IIa型35例,IIb型134例,IV型32例,V型68例。他们此前均已接受至少三个月的饮食治疗。之后,他们接受非诺贝特(力平之)治疗,剂量为100毫克,每天早上2粒,晚上1粒。治疗开始一个月后检查生化指标。IIa型、IIb型、IV型和V型患者的胆固醇(分别降低20%、17%、114%、224%)、甘油三酯(分别降低31%、37%、47%、704)、低密度脂蛋白胆固醇(分别降低23%、19%、11%无显著差异、31%)、极低密度脂蛋白胆固醇(分别降低25%、29%、32%、59%)、动脉粥样硬化指数(分别降低27%、28%、28%、55%)、尿素(分别降低5%无显著差异、21%、22%、28%)、γ-谷氨酰转移酶(分别降低23%、25%、15%无显著差异、39%)均显著下降(P<0.05),而高密度脂蛋白胆固醇值升高(分别为0%无显著差异、升高20%、12%、29%)。治疗期间碱性磷酸酶(分别降低8%、9%、11%、10%)、谷草转氨酶(分别降低3%、8%、升高5%、降低15%)、谷丙转氨酶(分别降低22%、升高4%、降低18%、降低15%)和血糖(分别降低17%有显著差异、降低5%、降低7%、降低10%)未观察到统计学上的显著变化。非诺贝特通过降低脂蛋白和尿酸水平降低动脉粥样硬化发生的风险。