微粒化非诺贝特对Ⅳ型高脂血症患者血清低密度脂蛋白亚组份再分布的作用  

Effects of micronized fenofibrate on low density lipoprotein subfraction profiles in type IV hyperlipidemic subjects

作　　者：诸骏仁[1] 韩琴琴[1] 赵振泽[1] 陈斌[1] 周庭川 叶为玲 

机构地区：[1]上海医科大学附属中山医院,上海市心血管病研究所200032

出　　处：《中华心血管病杂志》1999年第5期363-366,共4页Chinese Journal of Cardiology

摘　　要：目的　观察微粒化非诺贝特对IV型高脂血症患者血清低密度脂蛋白 (LDL)亚组份再分布的作用。方法　口服微粒化非诺贝特 2个月 ( 2 0 0mg ,每晚 1粒 ) ,共治疗患者 2 6例 ,对治疗后出现血清LDL 胆固醇水平升高 15 %以上的共 12例患者 ,进一步用超速离心法观察药物对血清LDL亚组份 (LDL1∶1 0 2 5g/ml～ 1 0 3 4g/ml,LDL2 ∶1 0 3 4g/ml～ 1 0 4 4g/ml和LDL3∶1 0 4 4g/ml～ 1 0 63g/ml)再分布的作用。结果　微粒化非诺贝特治疗后 ,血清甘油三酯 (TG)水平平均下降 5 3 4 %～ 64 4 % (P <0 0 0 1) ,LDL 胆固醇明显升高 3 7 3 %～ 79 4 % (P <0 0 0 1) ,总胆固醇、高密度脂蛋白 胆固醇水平无明显改变。治疗前患者的LDL亚组份分布以小而密LDL3为主 [LDL3占总LDL的 ( 3 4 7± 8 6) % ],分布曲线呈多峰、不均一态分布 ;治疗后LDL3比例显著降低 [降低 ( 3 5 0± 2 7 3 ) % ,P <0 0 0 1]、LDL2 显著升高 [升高 ( 4 6 9± 2 9 0 ) % ,P <0 0 0 1],LDL亚组份分布曲线转向单峰、较均一态分布。治疗后LDL颗粒的化学组成构成比 ( % )发生较大变动 ,其中TG %显著降低 (P <0 0 1) ,胆固醇酯 %和蛋白质 %不同程度增高 ,游离胆固醇 %和磷脂 %无明显变化。Objective To investigate the effects of micronized fenofibrate on low density lipoprotein (LDL) subfraction profiles in type IV hyperlipidemic subjects. Methods Micronized fenofibrate was administered 200 mg once a day to 26 type IV hyperlipidemic subjects for 2 months in the first active treatment phase, and in those 12 patients with a more than 15% increase of serum total LDL cholesterol (LDL C) after treatment a second 2 month active treatment phase was given. The changes of LDL subfractions (LDL 1,2,3) before and after the second treatment phase were investigated by ultracentrifugation. Results Serum triglyceride levels were decreased by 53.4%～64.4% after treatment. The serum LDL subfraction profiles, which showed a predominance of dense LDL subfraction with multi peak in the asymmetric LDL density profile at baseline, were normalised to a significant degree showing a single peak symmetric profile, as a result of preferential reduction in the elevated levels of dense subfraction LDL 3 and increment of middle subfraction LDL 2. Furthermore, micronized fenofibrate not only effectively reduced the elevated triglyceride content of all LDL subfractions, but also increased their cholesteryl ester and total protein content. Conclusion Micronized fenofibrate treatment in type IV hyperlipidemia results in significant decrease in serum triglyceride level and marked increase in LDL C level. The latter is intimately linked to distributional normalisation of the atherogenic LDL subfraction profile by marked triglyceride reduction.

关 键 词：高脂血症 密度脂蛋白 亚组份 诺贝特 

分 类 号：R589.205[医药卫生—内分泌] R972.6[医药卫生—内科学]