随机、双盲、安慰剂对照研究奥利司他对肥胖患者血清小而密低密度脂蛋白的影响  

Changes of LDL subfraction of obese patients treated with orlistat: a double-blind, placebo-controlled clinical trial

作　　者：胡予[1] 高鑫[1] 蒋小红[1] 诸骏仁[2] 

机构地区：[1]复旦大学附属中山医院内分泌科,上海200032 [2]复旦大学附属中山医院心脏科,上海200032

出　　处：《中华心血管病杂志》2003年第1期52-55,共4页Chinese Journal of Cardiology

摘　　要：目的　观察奥利司他对中国肥胖患者血清小而密低密度脂蛋白 (LDL)水平的影响。方法　这是一项随机、双盲、安慰剂对照研究。采用 3 %～ 1 6 %聚丙烯酰胺梯度凝胶电泳的方法测定血清LDL颗粒的大小。 68例符合入选标准的肥胖患者被随机分成奥利司他组和安慰剂组 ,治疗 2 4周。在治疗前和治疗后测量血清LDL颗粒的大小。结果　奥利司他治疗 2 4周后 ,平均LDL直径有明显的增大 (2 5 3nm比 2 5 9nm ,P =0 0 0 1 ) ,但安慰剂组在治疗前后没有明显的改变 (2 5 9nm比 2 5 6nm ,P =0 1 52 )。LDL直径的变化值在奥利司他组明显高于安慰剂组 (0 6nm比 - 0 2nm ,P =0 0 0 1 )。小而密LDL的比例在奥利司他组从 60 %下降到 2 8 9% (P =0 0 0 3) ,而在安慰剂组没有明显的改变(56 5 %比 56 5 % ,P =1 0 0 0 ) ,两组间差异有显著性 (P =0 0 39)。结论　奥利司他减重治疗 2 4周后 ,LDL的直径有显著增加 ,血清小而密LDL的比例有明显下降 ,这种改变较安慰剂组更为明显。Objective To study the effect of orlistat on small, dense LDL of Chinese obese patients as compared with placebo Methods A randomized, double blind, placebo controlled clinical trial was conducted 3%-16% gradient polyacrylamide gel electrophoresis was used for the measurement of the size of LDL particles Sixty eight eligible patients with obesity were randomized to orlistat or placebo treatment for 24 weeks Serum LDL particle size was measured before and after treatment Average LDL size less than 25 5 nm in diameter was regarded as LDL type B or small, dense LDL Results After 24 weeks′ treatment with orlistat, the average LDL size was significantly increased compared with pre treatment (25 3 nm vs 25 9 nm in diameter, P =0 001) But there was no significant difference of LDL size after 24 weeks′ treatment of placebo (25 9 nm vs 25 6 nm, P =0 152) The change of LDL size was significantly greater in the treatment group than that in the placebo group (0 6 nm vs -0 2 nm, P =0 001) The proportion of LDL type B was decreased from 60% to 28 9% in the orlistat group ( P =0 003), but there was no change in the placebo group(56 5% vs 56 5%, P =1 000) The difference between the two groups was significant( P =0 039) Conclusions The LDL particle size increases significantly and the percentage of LDL B type decreases significantly after 24 weeks′ anti obesity treatment with orlistat Anti obesity treatment with orlistat may increase the LDL size and presumably decrease the risk of development of cardiovascular diseases

关 键 词：奥利司他 脂蛋白类 LDL 肥胖症 血清 治疗 统计学 

分 类 号：R589.2[医药卫生—内分泌]