微粒化非诺贝特对高三酰甘油血症患者血管内皮功能的作用  

Effect of micronised fenofibrate on the endothelial function in patients with hypertriglyceridemia

作　　者：黄芸[1] 戴闺柱[1] 冯宗忱[2] 鲁成发[3] 成蓓[1] 王秋芬[1] 聂福鼎[1] 李景东[1] 

机构地区：[1]华中科技大学同济医学院心血管病研究所华中科技大学同济医学院附属协和医院心内科 [2]华中科技大学同济医学院生化教研室 [3]华中科技大学同济医学院附属协和医院超声科

出　　处：《临床心血管病杂志》2003年第8期481-483,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨微粒化非诺贝特对高三酰甘油血症患者血管内皮功能的作用。方法 :对 30例高三酰甘油血症患者 (口服微粒化非诺贝特 2 0 0mg/d治疗 4周前后 )和 30例正常人采用高分辨超声技术检测血流介导的和硝酸甘油介导的肱动脉舒张功能 ,并测定血浆内皮素 (ET)和血脂。结果 :①高三酰甘油血症组血流介导的肱动脉舒张反应较正常组明显减弱 [(2 .7± 2 .0 ) %∶(15 .0± 8.0 ) % ,P <0 .0 1],而两组对硝酸甘油的血管舒张反应差异无显著性意义 [(15 .0± 5 .0 ) %∶(16 .8± 9.0 ) % ,P >0 .0 5 ]。②高三酰甘油血症患者微粒化非诺贝特治疗后血流介导的肱动脉舒张显著改善 [(11.0± 9.0 ) % ,P <0 .0 1],而硝酸甘油介导的血管舒张较治疗前无明显改变[(16 .2± 6 .0 ) % ,P >0 .0 5 ]。③高三酰甘油血症患者血浆ET水平显著高于正常人 [(10 6 .2± 19.2 ) μg/L∶(72 .4± 14 .1) μg/L ,P <0 .0 1],微粒化非诺贝特治疗后血浆ET水平显著降低 [(82 .7± 15 .5 ) μg/L ,P <0 .0 1],血清三酰甘油明显降低 (P <0 .0 5 )。结论 :微粒化非诺贝特对高三酰甘油血症患者受损的血管内皮依赖性舒张功能有改善作用。Objective:To investigate the effect of micronised fenofibrate on the endothelial function in patients with hypertriglyceridemia.Methods:With high resolution ultrasound, flow and nitroglycerin induced dilatation of the brachial artery were measured in thirty hypertriglyceridemic patients before and after the treatment with micronised fenofibrate at a dose of 200 mg once daily for 4 weeks and thirty healthy subjects as controls. Both serum lipid and plasma endothelin (ET) were also determined.Results:①In patients with hypertriglyceridemia, flow induced vasodilatation was much reduced compared with that in the control subjects[( 2.7 ± 2.0 )% vs ( 15.0 ± 8.0 )%, P< 0.01 ]. However, vasodilatation in response to nitroglycerin were similar in both groups [( 15.0 ± 5.0 )% vs ( 16.8 ± 9.0 )%, P> 0.05 ]. ②After micronised fenofibrate therapy, flow induced vasodilatation was improved [( 11.0 ± 9.0 )%, P< 0.01 ], however, no significant change of vasodilatation in response to nitroglycerin was observed [( 16.2 ± 6.0 )%, P> 0.05 ] in patients with hypertriglyceridemia. ③Plasma ET in hypertriglyceridemic patients was significantly higher than that in the control subjects [( 106.2 ± 19.2 )μg/L vs ( 72.4 ± 14.1 )μg/L, P< 0.01 ]. After micronised fenofibrate therapy, both plasma ET [( 82.7 ± 15.5 )μg/L, P< 0.01 ] and serum triglyceride (TG) decreased significantly (P< 0.01 and P< 0.05 ) in hypertriglyceridemic patients.Conclusion:Micronised fenofibrate therapy could improve the impaired endothelium dependent vasodilatation in patients with hypertriglyceridemia. Improving endothelial function may also be the mechanism for the beneficial effects of micronised fenofibrate.

关 键 词：高三酰甘油血症 内皮 血管 微粒化非诺贝特 降血脂药 

分 类 号：R589.2[医药卫生—内分泌] R329[医药卫生—内科学]