Primer dislipidemililerde diyet ve statinlerin etkileri
Küçük Resim Yok
Tarih
1998
Yazarlar
Ulucan, Şeref
Altınbaş, Ahmet
Tokaç, Mehmet
Özdemir, Kurtuluş
Korkut, Bayram
Gök, Hasan
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamıza primer dislipidemi tanısı konmuş 80 (44 erkek, 36 kadın ve yaş ortalamaları 48.8 yıl) olgu dahil edildi. Hastalar dört gruba ayrıldı. Birinci gruba sadece diyet, diğer gruplara sırası ile diyetle birlikte 20mg pravastatin, 10mg simvastatin, 40mg fluvastatin 24 hafta boyunca uygulandı. Başlangıç, 6, 12, 18 ve 24. haftalarda TK, HDL-K, LDL-Kve TG tayinleri yapıldı. Etkinliği değerlendirmede tedavinin başlangıç ve 24. hafta sonunda kan lipid düzeyleri arasındaki % değişim (%95 güven aralığı) göz önüne alındı. Hastalar ayrıca AST, ALT, LDH, CPK, üre, kreatinin, ürik asit, sodyum, potasyum, bilirübin ve hemoglobin değerleri ile hepatotoksisite, miyozit, hematolojik ve biyokimyasal anormallikler yönünden izlendi. Diyet uygulanan grupta TK -%16, LDL-K -%16.9 ve TG -%26.9 düşerken, HDL-K % 12.8yükseldi. Pravastatinle TK -%28.7, LDL-K -%21.6 ve TG -%32.3 azalma gösterirken, HDL-K'de sadece %3.5 artış bulundu. Simvastatin uygulanan hastalarda TK -%32.1, LDL-K -%33.2, TG-%20.6 düşer-ken, HDL-K %16. l artış gösterdi. Fluvastatin uygulanan olgularda ise TK'de -%26.7, LDL-K'de -%25.5, TG'de -%17. l azalma görüldü. Buna kar-şılık HDL-K'de %17.3 artış bulundu. TK, LDL-K ve TG; dört grupta da anlamlı olarak düşüktü. HDL-K düzeyi ise pravastatin grubunda anlamlı değişme göstermedi. Bu az değişimde de hastaların gerek ilaç kullanımı; gerekse yaşam tarzlarmdaki uyum bozukluğu ve olgu sayısının az olmasının rolünün olabileceği düşünüldü. TK ve LDL-K değişimleri bakımından her üç Hacın istatistiksel olarak birbirlerine üstün olmadıkları (p0.05), ancak yalnız diyet uygulamasına göre her üç ilacın da TK ve LDL-K'ü düşürme bakımından oldukça anlamlı üstünlük sağladıkları görüldü (p0.0001 ve p0.004). TG ve HDL-K düzeylerini etkileme bakımından, gruplar arası anlamlı farklılık bulunmadı (pQ.05). ilaçlar hastalar tarafından iyi tolère edildi. Literatürlerde bahsedilen hepatotoksisite ve miyozite rastlanmadı. Primer dislipidemili hastalarda HMG-CoA redüktaz inhibitörleri TK, LDL-K ve TG düzeylerini etkili şekilde düşürmektedir, ilaçlara tahammülün oldukça iyi olması nedeniyle, daha yüksek dozlarda uygulanarak NCEP ATP II 'nin önerdiği lipid düzeylerine daha da yaklaşılabileceği, böylece gerek primer, gerekse sekonder korumayla KKH'na bağlı morbidité ve mortalitede beklenenden daha fazla azalma sağlanabileceği kanaatine varıldı.
In this clinical study; we aimed to investigate the safety and efficacy of diet and HMG-CoA reductase inhibitors in a period of 24 weeks in patients with primary dyslipidemia. Eighty individuals (44 males, 36 females and mean age 48.8 years) were included in the study. The study population was divided into four groups; diet group, pravastatin group (20mg/day), simvastatin group (lOmg/day), fluvastatin group (40mg/day). In addition to TC (total chlesterol), HDL-C (high density lipoprotein-cholesterol), LDL-C flow density lipoprotein-cholesterol) and TG (triglycéride) levels; lipid electrophoresis and exercise stress testing was performed in the beginning of the study. Lipid values were controlled at 6{th}, 12{th}, 18{th} and 24{th} weeks. To determine the efficacy of treatment; the % change of lipid levels was calcu lated (95% confidence interval). The patients were also monitored for clinical and laboratory side effects.There was no statistically significant difference according to age, sex, HT, CHD, cigarette smoking, EMI and family history between the study groups. In the diet group, while TC (16%,p<0.001), LDL-C (16.9%) and TG (26.9%) levels were reducing, HDL-C (12.8%,p<0.001) was increased. (28%,p<0.0001), LDL-C (21.6%) and TG (32.2%, p<0.0003) leve!s were decreased by pravastatin, there was increase only HDL-C levels (3.5%,p<0.002). In the fluvastatin group, there was decrease in TG levels (%26.7,p<0.01) but increase was found HDL-C levels (17.3 %.p<0.01).At the end of the study ; TC,LDL-C and TG levels were significantly decreased in all of the four study groups, HDL-C level showed no significant change in the pravastatin group. There was no superiority of all the three drugs to each other in altering TC, LDL-C, TG and HDL-C levels , but all of them were superior in decreasing TC and LDL-C levels when compared to diet group. The drugs were well tolerated by the patients; there was no hepatotoxicity and myositis and any other clinically significant side effect. İn conclusion HMG-CoA reductase inhibitors decresed TC,LDL-C and TG levels effectively with high tolerability when compared to diet in patients with primary hypercholesterolemia.
In this clinical study; we aimed to investigate the safety and efficacy of diet and HMG-CoA reductase inhibitors in a period of 24 weeks in patients with primary dyslipidemia. Eighty individuals (44 males, 36 females and mean age 48.8 years) were included in the study. The study population was divided into four groups; diet group, pravastatin group (20mg/day), simvastatin group (lOmg/day), fluvastatin group (40mg/day). In addition to TC (total chlesterol), HDL-C (high density lipoprotein-cholesterol), LDL-C flow density lipoprotein-cholesterol) and TG (triglycéride) levels; lipid electrophoresis and exercise stress testing was performed in the beginning of the study. Lipid values were controlled at 6{th}, 12{th}, 18{th} and 24{th} weeks. To determine the efficacy of treatment; the % change of lipid levels was calcu lated (95% confidence interval). The patients were also monitored for clinical and laboratory side effects.There was no statistically significant difference according to age, sex, HT, CHD, cigarette smoking, EMI and family history between the study groups. In the diet group, while TC (16%,p<0.001), LDL-C (16.9%) and TG (26.9%) levels were reducing, HDL-C (12.8%,p<0.001) was increased. (28%,p<0.0001), LDL-C (21.6%) and TG (32.2%, p<0.0003) leve!s were decreased by pravastatin, there was increase only HDL-C levels (3.5%,p<0.002). In the fluvastatin group, there was decrease in TG levels (%26.7,p<0.01) but increase was found HDL-C levels (17.3 %.p<0.01).At the end of the study ; TC,LDL-C and TG levels were significantly decreased in all of the four study groups, HDL-C level showed no significant change in the pravastatin group. There was no superiority of all the three drugs to each other in altering TC, LDL-C, TG and HDL-C levels , but all of them were superior in decreasing TC and LDL-C levels when compared to diet group. The drugs were well tolerated by the patients; there was no hepatotoxicity and myositis and any other clinically significant side effect. İn conclusion HMG-CoA reductase inhibitors decresed TC,LDL-C and TG levels effectively with high tolerability when compared to diet in patients with primary hypercholesterolemia.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
MN Kardiyoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
3
