Sinzinger H, Pirich C
Wilhelm Auerswald Atherosclerosis Research Group, Vienna.
Wien Klin Wochenschr. 1994;106(23):721-7.
The therapeutic effects of the HMG-CoA reductase inhibitor pravastatin on plasma lipids were assessed in an open, prospective, multicenter trial over a treatment period of 3 months. Of a total of 1111 patients, the overall results were calculated from 715 evaluable patients (352 men and 363 women, mean age: 56.1 +/- 11.3 years) with primary isolated hypercholesterolemia (hyperlipoproteinemia type IIa according to Fredrickson) being at high risk for cardiovascular disease according to the classification of the national cholesterol consensus, whose guidelines are distinguishing between three risk levels (low, moderate, and high, respectively) of total-cholesterol (total-c) as well as LDL-c. The treatment period was preceded by a 3-month dietary counselling phase. Treatment with pravastatin significantly reduced total-c (23.8%, p < 0.001), LDL-c (31.9%, p < 0.001) and triglyceride (16.9%, p < 0.001) levels, concomitantly those of HDL-c were significantly raised (15%, p < 0.001). Pravastatin lowered the total-c/HDL-c ratio by nearly 36% from a mean of 8.1 +/- 2.5 to a mean of 5.2 +/- 1.6. At the end 476 patients (66.6%) received the standard dosage of 10 mg/day whereas 140 patients (19.6%) were recorded to take a dose of 20 mg/day. When comparing those patients (n = 456) having maintained consistently a dose of 10 mg pravastatin per day from week 0 to week 12 with patients (n = 113) who received 20 mg/day from week 4 to 12 similar efficacy was observed in both groups (reduction of total-c: 24.5% vs. 22.2%, n.s., reduction of LDL-c: 33.0% vs. 30.0%, n.s.).(ABSTRACT TRUNCATED AT 250 WORDS)
在一项为期3个月的开放、前瞻性、多中心试验中,评估了HMG-CoA还原酶抑制剂普伐他汀对血脂的治疗效果。在总共1111名患者中,总体结果是根据715名可评估患者(352名男性和363名女性,平均年龄:56.1±11.3岁)计算得出的,这些患者患有原发性单纯性高胆固醇血症(根据弗雷德里克森分类为IIa型高脂蛋白血症),根据国家胆固醇共识分类,他们患心血管疾病的风险很高,该共识指南区分了总胆固醇(total-c)以及低密度脂蛋白胆固醇(LDL-c)的三个风险水平(分别为低、中、高)。治疗期之前有一个为期3个月的饮食咨询阶段。普伐他汀治疗显著降低了总胆固醇(23.8%,p<0.001)、低密度脂蛋白胆固醇(31.9%,p<0.001)和甘油三酯(16.9%,p<0.001)水平,同时高密度脂蛋白胆固醇水平显著升高(15%,p<0.001)。普伐他汀使总胆固醇/高密度脂蛋白胆固醇比值从平均8.1±2.5降至平均5.2±1.6,降低了近36%。在试验结束时,476名患者(66.6%)接受10毫克/天的标准剂量,而有140名患者(19.6%)记录服用20毫克/天的剂量。将那些从第0周至第12周一直维持每天10毫克普伐他汀剂量的患者(n = 456)与从第4周至第12周接受20毫克/天剂量的患者(n = 113)进行比较,两组观察到相似的疗效(总胆固醇降低:24.5%对22.2%,无显著性差异;低密度脂蛋白胆固醇降低:33.0%对30.0%,无显著性差异)。(摘要截断于250字)