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[苯扎贝特与氯贝丁酯治疗原发性高脂蛋白血症患者的比较双盲研究]

[Comparative double-blind investigation of bezafibrate and clofibrate in patients with primary hyperlipoproteinaemia].

作者信息

Lageder H

出版信息

Wien Klin Wochenschr. 1980 Feb 1;92(3):95-101.

PMID:6985560
Abstract

The lipid-reducing effects of bezafibrate and clofibrate were investigated in a double-blind crossover trial. 3 x 200 mg/d bezafibrate and 3 x 500 mg/d clofibrate were administered for periods of 8 weeks each to 22 patients with primary hyperlipoproteinaemia (9 Type IIb, 13 Type IV). Placebo periods preceded and followed the periods of medication. Compliance was checked by determination of the serum concentrations of bezafibrate and clofibrate. As compared with the pre-therapy value under placebo, cholesterol was reduced by 14% with bezafibrate and 7% with clofibrate in the group as a whole. In Type IIb patients cholesterol was reduced by 16% with bezafibrate as against 10% with clofibrate, and in Type IV patients by 12% with bezafibrate and 6% with clofibrate. A similar response was found in triglyceride reduction: 36% vs. 18% for the group as a whole; 47% vs. 31% for Type IIb; and 29% vs. 9% for Type IV. The difference in triglyceride reduction for the group as a whole was significant at the p less than 0.05 level. Body weight, pulse rate, and blood pressure showed no changes during the entire period of investigation. Fasting blood glucose was somewhat lower under both substances than under the subsequent placebo period while urea-N and creatinine was increased for both as compared with both pre- and post-therapy placebo periods. Under bezafibrate there was an increase in CPK as compared with the second placebo phase. There were no changes in GOT and GPT. Reductions in gamma-GT, alkaline phosphatase, and bilirubin were observed under both bezafibrate and clofibrate, as were slight decreases in haemoglobin, erythrocytes, and leucocytes, and a small increase in thrombocytes. No changes in urinary excretion of protein or glucose were observed. No subjective side effects were reported, either for bezafibrate or for clofibrate.

摘要

在一项双盲交叉试验中研究了苯扎贝特和氯贝丁酯的降脂效果。将3×200mg/d的苯扎贝特和3×500mg/d的氯贝丁酯分别给予22例原发性高脂蛋白血症患者(9例IIb型,13例IV型),各用药8周。用药期前后各有一段安慰剂期。通过测定血清中苯扎贝特和氯贝丁酯的浓度来检查依从性。与安慰剂治疗前的值相比,总体上苯扎贝特使胆固醇降低了14%,氯贝丁酯使胆固醇降低了7%。在IIb型患者中,苯扎贝特使胆固醇降低了16%,而氯贝丁酯使胆固醇降低了10%;在IV型患者中,苯扎贝特使胆固醇降低了12%,氯贝丁酯使胆固醇降低了6%。在甘油三酯降低方面也发现了类似的反应:总体上分别为36%和18%;IIb型分别为47%和31%;IV型分别为29%和9%。总体上甘油三酯降低的差异在p<0.05水平具有显著性。在整个研究期间,体重、脉搏率和血压均无变化。两种药物治疗时的空腹血糖均略低于随后的安慰剂期,而尿素氮和肌酐与治疗前及治疗后的安慰剂期相比均有所升高。与第二个安慰剂期相比,苯扎贝特治疗时肌酸磷酸激酶升高。谷草转氨酶和谷丙转氨酶无变化。苯扎贝特和氯贝丁酯治疗时均观察到γ-谷氨酰转移酶、碱性磷酸酶和胆红素降低,血红蛋白、红细胞和白细胞略有减少,血小板略有增加。未观察到尿蛋白或尿糖排泄的变化。未报告苯扎贝特或氯贝丁酯有主观副作用。

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