依托贝特降低多代谢综合征患者的因子VII和纤维蛋白原水平。

M Jastrzebska, B Torbus-Lisiecka, J Pieczul-Mróz, K Chelstowski, J Kopciewicz, M Naruszewicz
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引用次数: 0

摘要

依托贝特是一种降血脂药物,属于贝特类。通过改善血脂,这些药物往往对缺血性心脏病的止血危险因素产生有利影响。我们提出了一项关于依托贝特对血脂和脂蛋白的影响的初步研究,以及对因子VII和纤维蛋白原的影响。研究组由18名男性组成,年龄52.5±7.3岁,伴有高甘油三酯血症或混合高脂蛋白血症及其他动脉粥样硬化危险因素,特别是胰岛素依赖型糖尿病和动脉高血压。根据是否存在动脉性高血压进一步分为两个亚组。所有患者服用依托贝特500毫克,连续3个月。与初始值相比,整个研究组在以下方面都有所下降:甘油三酯水平(226.0 +/- 27.1 vs. 288.0 +/- 51.9 mg/dl;p < 0.05), ldl -胆固醇百分比(72.4 +/- 1.8比75.8 +/- 1.7;p < 0.05),载脂蛋白B (111.2 +/- 4.6 vs 115.3 +/- 5.4 mg/dl;p < 0.05),动脉粥样硬化指数:LDL/HDL(5.06 +/- 0.58∶5.95 +/- 0.50;p < 0.02),载脂蛋白B和A (apoB/apoA)(0.92 +/- 0.04∶1.02 +/- 0.06;P < 0.05)。高密度脂蛋白胆固醇百分比增加(14.7 +/- 1.1 vs 12.8 +/- 0.7;p < 0.05)和apoA (121.0 +/- 4.8 vs. 111.2 +/- 2.4 mg/dl;P < 0.05)。因子VII (FVIIc)水平显著降低(114 +/- 5.9 vs. 136 +/- 5.3%;P < 0.001)和纤维蛋白原(2.95 +/- 0.17比3.58 +/- 0.17 g/l;P < 0.01)。纤维蛋白原水平显著下降(3.09 +/- 0.30 vs. 3.87 +/- 0.34 g/l;p < 0.05), F1 + 2指标呈下降趋势(2.32 +/- 0.53∶2.74 +/- 0.37 nmol/l;NS)。动脉压正常的患者维持纤维蛋白原水平(3.23 +/- 0.24 vs. 3.36 +/- 0.26 g/l;NS)。治疗期间FVIIc与F1 + 2呈正相关。所有结果均以算术平均值+/- SE表示。目前的研究表明,依托贝特在多代谢综合征患者中具有降血脂、抗血栓和抗动脉粥样硬化的特性。
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Etofibrate decreases factor VII and fibrinogen levels in patients with polymetabolic syndrome.

Etofibrate is a hypolipemic drug belonging to the fibrate class. By improving the lipid profile, these drugs often exert a favorable influence on hemostatic risk factors of ischemic heart disease. We present a pilot study on the influence of etofibrate on lipids and lipoproteins in serum, as well as on factor VII and fibrinogen. The study group was comprised of 18 males, aged 52.5 +/- 7.3 years, with hypertriglyceridemia or mixed hyperlipoproteinemia and other risk factors of atherosclerosis, particularly insulin-dependent diabetes and arterial hypertension. The group was further divided into two subgroups depending on the coexistence of arterial hypertension. All patients received etofibrate 500 mg daily for 3 months. In comparison with initial values, a decrease in the following was noted for the whole study group: triglyceride level (226.0 +/- 27.1 vs. 288.0 +/- 51.9 mg/dl; p < 0.05), percent LDL-cholesterol (72.4 +/- 1.8 vs. 75.8 +/- 1.7; p < 0.05), apolipoprotein B (111.2 +/- 4.6 vs. 115.3 +/- 5.4 mg/dl; p < 0.05), atherogenic indices: LDL/HDL (5.06 +/- 0.58 vs. 5.95 +/- 0.50; p < 0.02) and apolipoprotein B and A (apoB/apoA) (0.92 +/- 0.04 vs. 1.02 +/- 0.06; p < 0.05). There was an increase in percent HDL-cholesterol (14.7 +/- 1.1 vs. 12.8 +/- 0.7; p < 0.05) and apoA (121.0 +/- 4.8 vs. 111.2 +/- 2.4 mg/dl; p < 0.05). A marked decrease in the level of factor VII (FVIIc) (114 +/- 5.9 vs. 136 +/- 5.3%; p < 0.001) and fibrinogen (2.95 +/- 0.17 vs. 3.58 +/- 0.17 g/l; p < 0.01) was found. Fibrinogen levels fell notably (3.09 +/- 0.30 vs. 3.87 +/- 0.34 g/l; p < 0.05) in the subgroup with arterial hypertension, and F1 + 2 markers tended to decline (2.32 +/- 0.53 vs. 2.74 +/- 0.37 nmol/l; NS). Patients with normals arterial pressure maintained their fibrinogen levels (3.23 +/- 0.24 vs. 3.36 +/- 0.26 g/l; NS). A positive correlation between FVIIc and F1 + 2 was observed during treatment. All results were expressed as arithmetic means +/- SE. The present study has demonstrated that etofibrate has hypolipemic, antithrombotic and antiatherosclerotic properties in patients with polymetabolic syndrome.

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