450 [ ]1007-7669(2013)06-0450-06 A 赵水平 1 陈雅琴 1 陈君柱 2 来江涛 2 (1. 410011; 2. 310003) [ ] A; ; ; ; ; ; [ ] 目的 A 方法 417 (TG) 2.3 ~ 6.5 mmol L -1 (n = 207) A (n = 210) 200 mg A 400 U 8 0 4 8 TG (TC) (HDL- C) (LDL- C) A 结果 4 A TG 17.3% 31.6%; 8 A 23.8% 33.1% (P < 0.01) A HDL- C (P < 0.01) TC LDL- C (P > 0.05) A (P < 0.01) 结论 A TG TG A A [ ] R541.4 [ ] A Comparison of effects and safety of coenzyme A and fenofibrate in patients with dyslipidemia ZHAO Shui- ping 1 CHEN Ya- qin 1 CHEN Jun- zhu 2 LAI Jiang- tao 2 ( 1. Department of Cardiology the Second Xiangya Hospital Changsha HU - NAN 410011 China; 2. Department of Cardiology the First Hospital Attached to the Medical School of Zhejiang University Hangzhou ZHEJIANG 310003 China) [ KEY WORDS] acetyl - CoA; fenofibrate; dyslipidemia; hypertriglyceridemia; adverse drug reactions; randomized controlled trials; multicenter studies [ABSTRACT] AIM This study was designed to compare the effects and safety of coenzyme A (CoA) and fenofibrate on plasma lipid levels in the patients with dyslipidemia. METHODS In the prospective [ ] 2012-01-13 [ ] 2012-11-13 [ ] E-mail: zhaosp@medmail.com.cn; E-mail: aviva9903@yahoo.com.cn [ ]
451 randomized placebo - controlled double - blind multi - centre phase clinical trial 417 patients with hyperlipidemia (TG 2.3-6.5 mmol L -1 ) were randomly divided into two groups and treated with CoA 400 U d -1 (n = 210) and fenofibrate 200 mg d -1 (n = 207) respectively for 8 weeks. After 4 weeks and 8 weeks blood routine urine routine hepatic and renal function blood glucose blood lipid and creatine kinase were measured. The primary end - point efficacy outcome is the TG lowing efficacy and the secondary efficacy parameters are variation rate of plasma total cholesterol ( TC) low- density lipoprotein cholesterol ( LDL- C) and high - density lipoprotein cholesterol ( HDL - C) and adverse events were compared after the treatment. RESULTS After the treatment for 4 weeks TG level reduce 31.6% and 17.3% respectively in the fenofibrate group and the CoA group. After the treatment for 8 weeks TG was significantly reduced 33.1% and 23.8% in two groups respectively. The difference between two groups was significantly ( P < 0.01). Compared with the fenofibrate group the increase of HDL- C in the CoA group was lower (P < 0.01). After the treatment there was no significant difference of LDL - C TC lowing rate between two groups. There were less drug - related adverse events in the CoA group than in the fenofibrate group and difference was significant. CONCLUSIONS It was showed that the TG lowing effect of fenofibrate 200 mg d -1 was better than CoA 400 U d -1. But CoA 400 U d -1 was with better safety and tolerance in the moderate dyslipidemia patients than fenofibrate. (TG) [1 2] TG 20% ~ 50% [3] TG 13 2010 7 2011 7 417 376 [4] TG A 400 U d -1 TG : (1) 18 ~ [5 6] 75 ; (2) TG 2.3 ~ 6.5 mmol L -1 ; (3) A 48 h ; (5) A : 100 ; (3) BMI > 30 kg m -2 ; (4) 080801 : (ALT) ( ); (AST) 2 ; (5) : 200 mg 13904 : 179 μmol L -1 ; ( (6) ( 180 mmhg ) ; (4) (1) TC 7.0 mmol L -1 ; (2) 110 mmhg); (7) 1 2 ( 10.0 mmol L -1 ); (8) 2 ; (9)
452 ; (10) ; (11) (2) 0-1 ; (12) 0 6 ; (13) 3 (3) 4 ; (14) 12 h ; (15) HIV ; (16) (4) 8 ( ) 1 (7170A ; (17) ) TG TC HDL- C LDL- C ( ) ; (18) 3 ; (19) TG 20% 1 1. : 4 8 2 TG 20%; TG 2. (20) ; (21) : ( 1) 4 8 TC LDL - C ; (22) HDL- C (2) ( ) TG 40% HDL- C > 0.1 mmol L -1 : (1) (TC-HDL- C) /HDL- C 20%; b. ; (2) TC 10% ~ 20% TG 20% ~ 40% HDL- ( C 0.1 ~ 0.26 mmol L -1 (TC-HDL- C) /HDL- C ); (3) ; (4) d. TC 10% TG 10% ; (5) HDL - C 0.1 mmol L -1 ( TC -HDL - C) / HDL- C 10% = ( + : (1) ) / 100% ; (2) ; (3) ; (4) ; 417 (n = 207 21 1 ) A (n = 210 19 0 ) 376 A 2 A ( 100 U); 2 1 (200 mg) 1 4 x ± s 4 : (1) -1 P < 0.025 P < 0.05 (TC) TG (HDL- C) -20 : a. TC 20% 10% ~ 20%; c. ; ; ; SPSS l0.0 (LDL- C) LOCF ( last observation
453 carrying forward) 4 TG 0.70 mmol L -1 (PPS) 17.3%; 8 0.93 mmol ( SS) L -1 23.8% 4 (ANCOVA) TG (P < 0.01) 8 TG (P > 0.05) (Lsmean) 95% (CI) 2 A 95%CI 95% 8 TG [ 10.52 95% CI CI 6% (3.76-17.29)] 95%CI 6% TG A TG A TG 3 3 (TC) (HDL- C) (LDL- C) A x ± s mmol L -1 TG TC LDL- C HDL- C A TG 4 TG 1.12 mmol L -1 31.6%; 8 1.19 mmol L -1 33.1% A 2 A TG x ± s mmol L -1 n 4 8 207 3.39 ± 0.99 2.27 ± 1.37-1.12 ± 1.39 c 2.20 ± 1.26-1.19 ± 1.33 c A 210 3.59 ± 1.10 2.89 ± 1.58-0.70 ± 1.50 cf 2.65 ± 1.46-0.93 ± 1.46 cd t : c P < 0.01; d P > 0.05 f P < 0.01 1 (n = 207) A (n = 210) TC 5.23 ± 0.87 5.25 ± 0.86 8 5.06 ± 0.91 5.06 ± 0.97-0.17 ± 0.86 a -0.19 ± 0.85 ad 1 x ± s HDL- C 1.10 ± 0.28 1.10 ± 0.29 8 1.22 ± 0.31 1.12 ± 0.24 A 0.12 ± 0.31 c 0.03 ± 0.29 af (n = 207) (n = 210) LDL- C 2.92 ± 0.85 2.85 ± 0.87 / 54.3 ± 12.3 53.1 ± 12.4 8 2.94 ± 0.77 2.81 ± 0.82 118 122 0.02 ± 0.85 a -0.04 ± 0.81 ad 89 88 /kg m -2 25.4 ± 2.2 25.0 ± 2.3 23.7 ± 2.6 23.7 ± 2.6 /mmhg 128.0 ± 13.5 127.1 ± 12.8 /mmhg 79.5 ± 8.6 78.8 ± 7.8 / min -1 71.7 ± 7.9 71.1 ± 7.6 / 46.9 ± 66.6 40.2 ± 54.9 /mmol L -1 3.39 ± 0.99 3.59 ± 1.10 /mmol L -1 5.23 ± 0.87 5.25 ± 0.86 /mmol L -1 2.92 ± 0.85 2.85 ± 0.87 /mmol L -1 1.10 ± 0.28 1.10 ± 0.29 /mmol L -1 5.6 ± 1.1 5.5 ± 1.0 /U L -1 108.8 ± 59.7 102.9 ± 44.1 /U L -1 29.3 ± 14.0 28.1 ± 13.8 /U L -1 26.0 ± 9.4 25.0 ± 8.0 /mmol L -1 5.1 ± 1.2 5.1 ± 1.3 /μmol L -1 73.4 ± 17.7 75.4 ± 17.8 t : a P > 0.05 c P < 0.01; d P > 0.05 f P < 0.01 A 8 TC LDL- C (P > 0.05) HDL- C A (P < 0.01) 3 A 4 74.9% A 71.4%; 8 80.2% A 73.8% (P > 0.05) 4 χ 2 : P > 0.05 4 n / (%) 4 184 108 38 20 18 146 (79.3) A 8 184 121 35 10 18 156 (84.0) 4 184 75 68 17 26 143 (76.9) a 8 184 105 42 11 28 147 (79.0) a CMH : a P > 0.05 A
454 52 (25.1%) 200 mg d -1 TC 40 (19.3%) 16 (7.7%); A 20 (9.5%) 5 (2.4%) 11 (5.2%) TG A TG (P < 0.01) ALT AST 8 (3.9%) 20 (9.7%) 3 ( 1.4% ) ; A ALT AST 1 A (0.5%) 3 (1.4%) 2 ALT AST 5 A 5 A ALT AST (n = 207) (n = 210) /U L -1 29.25 ± 13.95 28.11 ± 13.76 8 36.51 ± 28.89 28.02 ± 14.43 7.41 ± 28.43 c -0.13 ± 15.07 af /U L -1 26.00 ± 9.40 25.01 ± 8.00 8 32.03 ± 19.14 25.04 ± 8.46 5.94 ± 20.23 c 0.18 ± 9.09 af /mmol L -1 5.06 ± 1.39 5.09 ± 1.32 8 5.52 ± 1.44 5.18 ± 1.43 0.44 ± 1.40 b 0.08 ± 1.40 ae /μmol L -1 73.40 ± 17.67 75.36 ± 17.84 8 77.70 ± 18.00 74.67 ± 18.59 3.82 ± 15.67 c -1.30 ± 15.61 af /mmol L -1 5.59 ± 1.14 5.49 ± 0.96 8 5.40 ± 0.82 5.36 ± 0.83-0.16 ± 1.03 a -0.12 ± 0.84 ad /U L -1 108.77 ± 59.66 102.85 ± 44.07 8 113.64 ± 60.97 104.69 ± 42.79 3.47 ± 67.32 a 0.55 ± 44.74 ad t : a P > 0.05 b P < 0.05 c P < 0.01; d P > 0.05 e P < 0.05 f P < 0.01 400 U d -1 A TG [1 2] TG A A LDL- C TG HDL- C LDL [10 11] LDL- C [12] [13 14] A A TG A A [6-8] A A b : A β- TG A TG A [9] TG A A 400 U TG
455 [ ] [1] MILLER M STONE NJ BALLANTYNE C et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association[J]. Circulation 2011 123(20): 2292-2333. [2] CHAPMAN MJ GINSBERG HN AMARENCO P et al. Triglyceride - rich lipoproteins and high - density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management[j]. Eur Heart J 2011 32(11): 1345-1361. [3] BARTER PJ RYE KA. Is there a role for fibrates in the management of dyslipidemia in the metabolic syndrome? [J]. Arterioscler Thromb Vasc Biol 2008 28(1): 39-46. [4] DAVIDSON MH ARMANI A McKENNEY JM et al. Safety considerations with fibrate therapy[j]. Am J Cardiol 2007 99 [7] McKEAGE K KEATING GM. Fenofibrate: a review of its use in dyslipidaemia[j]. Drugs 2011 71(14): 1917-1946. [8] JUN M FOOTE C LV J et al. Effects of fibrates on cardiovascular outcomes: a systematic review and meta- analysis [J]. Lancet 2010 375(9729): 1875-1884. [9]. A [J]. 2011 19(10): 833-837. [10] CHAPMAN MJ REDFERN JS McGOVERN ME et al. Optimal pharmacotherapy to combat the atherogenic lipid triad [J]. Curr Opin Cardiol 2011 26(5): 403-411. [11] TONSTAD S DESPRES JP. Treatment of lipid disorders in obesity[j]. Expert Rev Cardiovasc Ther 2011 9(8): 1069-1080. [12] WIERZBICKI AS MORRELL J HEMSLEY D et al. The effect of fibrate- statin combination therapy on cardiovascular events: a retrospective cohort analysis[j]. Curr Med Res Opin 2010 26 (9): 2141-2146. [13] ACCORD Study Group GINSBERG HN ELAM MB et al. (6A): 3C-18C. Effects of combination lipid therapy in Type 2 diabetes mellitus [5]. A [J]. N Engl J Med 2010 362(17): 1563-1574. [J]. 2012 31(5): 242-246. [14] FRANSSEN R VERGEER M STROES ES et al. Combination [6]. A statin - fibrate therapy: safety aspects[j]. Diabetes Obes Metab [J]. 2013 32(1): 42-2009 11(2): 89-94. 46. [ ]1007-7669(2013)06-0455-05 T 2 李锐钊 1 2 章斌 2 张丽 1 史伟 2 梁馨苓 2 刘双信 2 王文健 2 (1. 510515; 2. 510080) [ ] ; ; ; NFATC ; [ ] 目的 T 2 (NFAT2) 方法 NFAT2 11R- VIVIT NFAT2 ionomycin Western blot NFAT2 结果 NFAT2 20 mmol L -1 2 h NFAT2 ; Ionomycin NFAT2 (P > 0.05) 11R- VIVIT NFAT2 (P < 0.01) 11R- VIVIT (P > 0.05) 20 mmol L -1 48 h [ ] 2012-11-18 [ ] 2013-05-08 [ ] (81270784 81170683) [ ] E-mail: 15920309398@139.com [ ] E-mail: shiwei.gd@139.com