Löcsey L, Asztalos L, Kincses Z, Balázs G
1st Department of Medicine, University Medical School, Debrecen, Hungary.
Int Urol Nephrol. 1997;29(1):95-106. doi: 10.1007/BF02551424.
Hyperlipidaemia of 18 male and 20 female patients following successful renal transplantation was treated with daily 20 mg fluvastatin (Lescol) for 12 weeks. The patients were several months after transplantation, and their total cholesterol levels exceeded 6.5 mmol/l following an 8-week diet. The effect of fluvastatin on the levels of total cholesterol, HDL, LDL, triglyceride, Apo A1 and Apo B, as well as of lipoprotein(a) was examined. Furthermore, changes of the renal function (GFR-urea, creatinine, uric acid) and hepatic function (bilirubin, GOT, GPT, CPK, ALP) were followed up, together with the body weight and blood pressure. The results of the examinations are summarized as follows: Fluvastatin may be administered effectively and without side effects in a daily dose of 20 mg in appropriately selected renal transplant patients. The average total cholesterol values, which were 7.91 mmol/l in men and 7.78 mmol/l in women following the diet, were reduced by 22-25% (p < 0.001) after 6 and 12 weeks, respectively, of fluvastatin treatment. The levels of LDL also decreased significantly (p < 0.001): in response to a 20 mg evening dosage, reduction of more than 25% was observed in 78% of men and 65% of women. Reductions of the Apo B levels were more pronounced in the females (18.3% men vs. 21.2% women). The ratio C/HDL-C decreased both in men (from 5.49 to 4.19) and in women (from 4.83 to 4.02). The ratio Apo B/Apo A1 also decreased (men: from 0.86 to 0.73, women: from 0.73 to 0.66). The concentrations of HDL and Apo A1 did not increase significantly, the reductions in the levels of triglyceride and lipoprotein(a) were not considerable either. An increase in the levels of hepatic enzymes and CPK was not encountered during the administration of fluvastatin. In two patients the levels of serum bilirubin increased by 2-4 micromol/l. Three patients complained about temporary myalgias of the sacroiliac or lumbar region which, however, were not accompanied by elevated CPK levels. The monitored levels of cyclosporine, urea and creatinine did not increase significantly during the 12 weeks of treatment. Two patients had temporary gastric complaints.
对18例男性和20例女性肾移植成功后的高脂血症患者，每日服用20mg氟伐他汀（来适可），疗程12周。患者处于移植后数月，经8周饮食控制后其总胆固醇水平仍超过6.5mmol/l。研究了氟伐他汀对总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯、载脂蛋白A1（Apo A1）和载脂蛋白B（Apo B）以及脂蛋白（a）水平的影响。此外，还随访了肾功能（肾小球滤过率-尿素、肌酐、尿酸）和肝功能（胆红素、谷草转氨酶、谷丙转氨酶、肌酸磷酸激酶、碱性磷酸酶）的变化，以及体重和血压。检查结果总结如下：在适当选择的肾移植患者中，每日服用20mg氟伐他汀可有效给药且无副作用。饮食后男性平均总胆固醇值为7.91mmol/l，女性为7.78mmol/l，氟伐他汀治疗6周和12周后分别降低了22%-25%（p<0.001）。LDL水平也显著下降（p<0.001）：晚间服用20mg剂量后，78%的男性和65%的女性降低超过25%。女性Apo B水平的降低更为明显（男性降低18.3%，女性降低21.2%）。男性和女性的总胆固醇/HDL-C比值均下降（男性从5.49降至4.19，女性从4.83降至4.02）。Apo B/Apo A1比值也下降（男性：从0.86降至0.73，女性：从0.73降至0.66）。HDL和Apo A1浓度未显著升高，甘油三酯和脂蛋白（a）水平的降低也不显著。服用氟伐他汀期间未出现肝酶和肌酸磷酸激酶水平升高。2例患者血清胆红素水平升高2-4μmol/l。3例患者主诉骶髂或腰部区域出现暂时性肌痛，但肌酸磷酸激酶水平未升高。治疗12周期间，监测的环孢素、尿素和肌酐水平未显著升高。2例患者有暂时性胃部不适。
