Campbell N, Brant R, Stalts H, Stone J, Mahallati H
Department of Pharmacology, the Faculty of Medicine, the University of Calgary, Alberta, Canada.
Arch Intern Med. 1998 Jul 13;158(13):1461-3. doi: 10.1001/archinte.158.13.1461.
Acute decreases in intravascular volume are associated with increases in lipid levels. Furosemide causes acute changes in intravascular volume during prolonged therapy but is thought to have little effect on lipid levels.
To determine if there are daily acute rises in lipid and lipoprotein levels associated with changes in intravascular volume during long-term furosemide ingestion therapy, we performed a randomized, double-blind, placebo-controlled crossover study in 10 patients.
In the 8 hours after furosemide ingestion there were increases in levels of plasma cholesterol (10.1%; P = .001), high-density lipoprotein cholesterol (9.0%; P = .006), and apolipoprotein B (9.8%; P = .003). The increases in levels of triglycerides (11.5%; P = .17) and apolipoprotein A-1 (13.3%; P = .051) were of similar magnitude but more variable and did not achieve statistical significance. There was no substantial change in the total cholesterol-high-density lipoprotein cholesterol ratio (0.6%; 95% CI,-0.74% to 8.6%; P =.88).
This study indicates that there are acute increases in lipid levels after furosemide ingestion during prolonged therapy, which could affect the interpretation of lipid levels and cardiovascular risk in patients.
血管内容量急性减少与血脂水平升高有关。长期使用呋塞米治疗期间会引起血管内容量急性变化，但一般认为其对血脂水平影响不大。
为了确定长期服用呋塞米治疗期间血脂和脂蛋白水平的每日急性升高是否与血管内容量变化相关，我们对10名患者进行了一项随机、双盲、安慰剂对照的交叉研究。
服用呋塞米后的8小时内，血浆胆固醇水平升高（10.1%；P = 0.001）、高密度脂蛋白胆固醇水平升高（9.0%；P = 0.006）以及载脂蛋白B水平升高（9.8%；P = 0.003）。甘油三酯水平升高（11.5%；P = 0.17）和载脂蛋白A-1水平升高（13.3%；P = 0.051）幅度相似，但变化更大且未达到统计学意义。总胆固醇与高密度脂蛋白胆固醇比值无显著变化（0.6%；95%可信区间，-0.74%至8.6%；P = 0.88）。
本研究表明，长期治疗期间服用呋塞米后血脂水平会急性升高，这可能会影响患者血脂水平的解读及心血管疾病风险评估。
