Naito H K, McHenry M C, Lewis L A
Clin Chem. 1980 Jan;26(1):163-8.
We describe two cases of atypical dyslipoproteinemia due to drug-induction. This secondary form of lipoprotein abnormality is unique because the newly available drug, miconazole, apparently directly delipidated the alpha-lipoproteins in the bloodstream. On closer study we found that the delipidation was caused by the vehicle rather than the fungicide--more specifically, only by the polyethoxylated castor oil in the vehicle. It affects serum lipoproteins both in vitro and in vivo, and the effect is species-specific. In vitro studies indicate that it preferentially delipidates high-density lipoprotein rather than low-density lipoprotein. Because its effects on the serum lipoproteins of rats resemble those on man, and because aortic lesions were produced in rats injected daily (90 mL/L) with this substance, caution is indicated in long-term use of drugs containing this chemical component in the vehicle.
我们描述了两例因药物诱导导致的非典型血脂蛋白异常病例。这种继发性脂蛋白异常形式很独特，因为新上市的药物咪康唑显然直接使血液中的α脂蛋白脱脂。经过更深入研究，我们发现脱脂是由溶媒而非杀菌剂引起的——更具体地说，仅由溶媒中的聚乙氧基化蓖麻油引起。它在体外和体内均会影响血清脂蛋白，且这种影响具有物种特异性。体外研究表明，它优先使高密度脂蛋白脱脂，而非低密度脂蛋白。由于其对大鼠血清脂蛋白的影响与人相似，并且每天（90 mL/L）给大鼠注射该物质会导致主动脉病变，因此在长期使用含有该溶媒中这种化学成分的药物时需谨慎。
