非诺贝特联合他汀治疗200例经他汀调脂后的高三酰甘油血症的疗效和安全性观察

Clinical evaluation of Fenofibrate in treatment of hypertriglyceridema after the therapy of Statins

目的探讨非诺贝特治疗他汀调脂后的高三酰甘油(TG)血症临床效果。方法随机选择2008年11月至2010年4月门诊接受他汀调脂后的高TG患者200例,入选时已服用他汀类药物常规剂量≥3个月,晨口服非诺贝特100mg,晚继续口服原他汀类药物,每晚1次。结果联合用药后总胆固醇(TC)从(6.11±1.15)mmol/L下降至(5.20±0.82)mmol/L;低密度脂蛋白胆固醇(LDL-C)从(3.73±0.76)mmol/L下降至(3.17±0.31)mmol/L;TG从(2.90±0.49)mmol/L下降至(1.46+0.29)mmol/L;高密度脂蛋白胆固醇(HDL-C)从(0.89±0.28)mmol/L升高至(1.26±0.19)mmol/L;治疗前后比较P<0.05,差异均有统计学意义。治疗效果为显效197例,好转3例,无效0例,总有效率为100%(200/200)。治疗中有2例发生胃肠道反应,1例出现转氨酶升高,停药后恢复正常,肝、肾功能均正常,无肌痛发生。结论非诺贝特联合他汀治疗经他汀类调脂后的高TG血症疗效确切且具有良好的安全性。

Objective To explore clinical effects of Fenofibrate united Statins in treatment of hypertriglyceridema. Methods Two hundred patients with hypertriglyceridema who had taken Statins for more than three months were randomly selected from November 2008 to April 2010, and took Fenofibrate in the morning and Statins at night orally. Results After the treat- ment, the levels of TC, LDI. C and TG declined [the value for TC： from （6.11±1.15） mmol/L to （5.20±0.8） retool/L; for LDL-C： from （3.73±0.76） mmol/Lto （3. 17±0.31） mmol/L; forTG： from （2.90±0.49） mmol/Lto （1.46±0.29） mmol/L HDL-C level increased from （0.89±0.28） mmol/L to （1.26 ±0.19） mmol/L. There were significant difference between pretherapy and post-treatment （all P〈0.05）. The effect was healing in 197 cases, improved in 3 cases, invalid in 0 cases. The total effective rate was 100% （200/200）. During treatment, two patients suffered from gastrointestinal reaction, one case of transaminase increased. After discominuation, all were back to normal. The liver and renal function were all nor- mal, and no myalgia happened. Conclusion Combined application of Fenofibrate in treatment of hypertriglyeeridema after the therapy of Statins had definite effect and the side effect is small, but it still needs clinical further discussion and study.