微粒化非诺贝特对高脂血症患者血脂及尿酸代谢的影响  

Effects of micronized fenofibrate on lipid and uric acid metabolism in patients with hyperlipidemia

作　　者：李丽君[1] 陈红[1] 任景怡[1] 王岚[1] 罗宇[1] 

机构地区：[1]北京大学人民医院心脏中心,北京100044

出　　处：《北京大学学报（医学版）》2009年第5期541-544,共4页Journal of Peking University:Health Sciences

摘　　要：目的:观察微粒化非诺贝特对高甘油三酯合并高尿酸血症患者血脂及尿酸代谢的影响,并探讨其潜在机制。方法:共入选116例高甘油三酯合并高尿酸血症患者,每日顿服微粒化非诺贝特胶囊200 mg,疗程4周。观察治疗前和治疗4周后主要血脂参数、血尿酸(UA)、24小时尿尿酸的变化以及不良反应。结果:微粒化非诺贝特治疗4周:(1)患者血清甘油三酯(TG)下降最为显著,与基线相比较下降51%,血清高密度脂蛋白胆固醇(HDL-C)水平升高19%,此外,患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平也有一定程度的下降(分别为10%和12%)。(2)患者血尿酸水平由(462.8±73.5)μmol/L降至(320.1±83.0)μmol/L,下降幅度为28.3%,其中男性患者血尿酸水平下降29.8%,女性患者下降25.1%,差异均有统计学意义(P值均小于0.01),并且血尿酸水平降低与基线值无关。(3)患者尿尿酸排出明显增多,由(2 874.2±503.4)μmol/L增加至(3 604.2±769.7)μmol/L,升高36.0%,其中男性患者尿尿酸水平升高41.1%,女性患者升高33.4%(P值均小于0.01),而且非诺贝特治疗后所有患者尿酸清除分数均明显升高,提示非诺贝特治疗促进了尿酸的排泄。结论:微粒化非诺贝特能同时有效改善高甘油三酯合并高尿酸血症患者的血脂及尿酸代谢异常,明显促进尿尿酸排泄,且该作用不受基线水平的影响,与性别无关,具有良好的安全性和耐受性。Objective：To evaluate the efficacy and safety of micronised fenofibrate on lipid and uric acid metabolism in patients with hyperlipidemia. Methods： A total of 116 patients with hypertriglyceridemia and hyperuricemia received 200 mg micronised fenofibrate for 4 weeks. Physical and laboratory investigations of lipid profiles, serum uric acid, and 24 h urine uric acid, for adverse effects were assessed. Results： （ 1 ） Serum triglyceride （TG） was significantly reduced by 51%, whilst high density lipoprotein cholesterol （HDL-C） increased 24% after 4-week fenofibrate treatment. Moreover, serum total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C） were reduced by 10% and 12%, respectively. （2） Serum uric acid levels were significantly reduced by 28.3% [from （462.8 ±73.5） μmoL/L to （ 320. 1 ± 83.0 ） μmol/L ] after fenofibrate treatment, independent of baseline uric acid levels. There was no difference in serum uric acid changes between male gender and female gender （29.8% and 25.1%, respectively）. （3） Urine uric acid levels were increased by 36.0% [from （2 874.2 ±503.4） p.mol/L to （3 604. 2 ±769.7） μmol/L]. The urine uric acid changes were 41.1% in male gender group and 33.4% in female gender group. The uric acid clearance/creatinin clearance ratio was increased in all cases after treatment. Conclusion： Micronised fenofibrate treatment could significantly improve lipid and uric acid metabolism in patients with hypertriglyceridemia and hyperuricemia, and is ge-nerally safe and well tolerated. The anti-hyperuricemic effect of fenofibrate is a result of increasing the urinary excertion of uric acid, independent of baseline level and gender.

关 键 词：非诺贝特 高甘油三酯血症 高尿酸血症 代谢 

分 类 号：R589.2[医药卫生—内分泌]