摘要
目的了解微粒化非诺贝特对老年高脂血症的临床疗效和耐受情况。方法随机选择血清总胆固醇(TC)≥5.20mmol/L和(或)甘油三酯(TG)在2.00～5.65mmol/L之间者共52例。年龄60～76岁 ,平均65.8岁。其中高密度脂蛋白胆固醇(HDLC)男性<1.04mmol/L、女性<1.16mmol/L者10例。33例合并有高血压、冠心病(陈旧性心肌梗塞 ,稳定性心胶痛)或脑血管疾病。排除半年内患有心肌梗塞、脑血管意外、严重创伤或做过重大手术者。分为药物组(每天200mg口服8周)和安慰剂组。结果服药4周末 ,非诺贝特组血清TC、TG、低密度脂蛋白胆固醇(LDLC)和(TC_HDLC)/HDLC的比值与治疗前比较均明显降低(P<0.05或0.01) ,且显著低于安慰剂组(P<0.05或0.01)。8周末以上指标进一步下降 ,仍然显著低于安慰剂组(P<0.05或0.01) ,其下降幅度分别为32.9 %,53.7 %,29.4 %和41 9 %。而血清HDLC两次观察均显著高于安慰剂组。非诺贝特组服药4周后1例和安慰剂组服药8周后1例血清尿素氮为7.56～9.39mg/dl(高限7.5mg/dl)、非诺贝特组服药8周后1例和安慰剂组服药8周后1例血清肌酸激酶为133.2～258.41IU/L(高限130IU/L) ,但未出现临床症状。谷丙转氨酶和血糖无明显变化。结论微粒化非诺贝特具有降低TG、TC和LDLC以及升高HDLC作用 ,对老年患者具有良好的耐受性。
Aim To evaluate the curatice effect of micronised fenofibrate on primary hyperlipidemia in the elderly patients.Methods Fifty two old patients aged from 60 to 76 years, with primary hyperlipidemia with total serum cholesterol (TC) greater than 5.20 mmol/L(200 mg/dl) and /or triglyceride (TG) ranging from 2.0 to 5.7 mmol/L (180～500 mg/dl),were randomly allocated into the fenofibrate or the placebo group. Each case was given oral 200 mg micronised fenofibrate or placebo per day for eight weeks.Results After treatment for four weeks, the serum levels of TC, TG, low density lipoprotein cholesterol (LDLC), and the ratio of [TC_high density lipoprotein cholesterol (HDLC)]/HDLC were more significantly lowered, and the level of HDLC was more significantly increased, in the micronised fenofibrate group than in the placebo one, respectively (P<0.01 or P<0.05).After treatment for eight weeks, the similar effects were observed, and the lowering range of the serum levels of TC, TG, LDLC, and the ratio of (TC_HDLC)/HDLC in the fenofibrate group were separately 32.9%, 53.7%, 29.4% and 41.9%, which much higher than these in the placebo group (P<0.01 or P<0.05). The drug was well_tolerated by all patients and no significant side effect was observed.Conclusion The micronised fenofibrate is highly effective in lowering serum TG as well as effective in lowering TC and LDLC. This agent is safe and tolerable in the elderly patients with hyperlipidemia.
