• 作者： 何橈通; 陳錦巧; 徐舜君; 陳如菱; 郭清輝; 吳敏雄; 陳振傑; 葉振聲
• 作者服務機構： 榮民總醫院﹑內科部﹑新陳代謝科; 國防醫學院﹑內科學系
• 中文摘要： 為評估「百脂脫喜」(PERYCIT ) 之降血脂作用，本研究選取原發性高血脂症，及糖尿病合併高血脂症患者，各12例，加以觀察。實驗設計採取「雙盲隨機交錯及對照」之方式。每位病患均服用「百脂脫喜」及安慰劑各三個月，其先後次序，由隨機抽樣決定且平衡。藥量為每天口服三次，每次一錠250毫克，較國外報告之劑量為低（每日1.5至4公克）。以血中「空腹血漿糖」及「醣化血色素」作為糖尿病控制狀態之指標；並測定血中「總膽固醇」，「高密度血脂蛋白膽固醇」，三酸甘油酯等，並計算「總膽固醇」與「高密度膽固醇」濃度之比值，以觀察此藥之降血脂效果。無母數統計方法用以比較其與安慰劑差異之意義。結果顯示，在原發性組，此藥確能下降血中三酸甘油酯濃度，及降低「總瞻固醇與高密度血脂蛋白瞻固醇濃度之比值」，以及升高血中「高密度血脂蛋白瞻固醇」之濃度。在糖尿病組，血中三酸甘油脂濃度無變化，而血中「總瞻固醇」濃度稍呈無統計學意義之升高現象，但因血中「高密度血脂蛋白膽固醇」濃度亦稍昇高之故，造成此二者之比值呈有意義的下降。在藥物服用期間，其血糖與醣化血色素均有進步，但其進步之程度，與安慰劑服用期間並無差異，故此血脂效果不可歸因於糖尿病之控制改善，當歸因於藥物之效果。在服藥期問，僅有6位糖尿病組患者，有輕微及短暫之臉部潮紅現象，並無其他任何副作用。結論「百脂脫喜」可降低血脂，而可能減少動脈硬化之危險因子，亦可用於糖尿病合併高血脂症患者，亦有減少動脈硬化危險因子之效果，且不影響其糖尿病之控制。
• 英文摘要： Pentaerythritol tetranicotinate (Perycit ), at an oral dosage of 750 mg daily, was given to 12 patientswith idiopathic hyperlipidemia and to 12 patients with hyperlipidemia superimposed with diabetes mellitus(DM). With 2 months off-drug period as the baseline, each patient then received 3 months of placebo and 3montns or Perycit . The sequence or treatment was ranaomized and balanced in frequence. Blood gly-cosylated hemoglobin (HbA )and fasting plasma glucose (FPG) were used as indices of diabetic control.Serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and TC/HDL-C ratio were measured and calculated in order to compare the antilipemic effectiveness of Perycitwith that of placebo. The non-parametric Wilcoxon test was used for the statistical analysis. The resultsshowed that in the idiopathic group, Perycit significantly lowered the serum level of TG and the ratio ofTC/HDL-C, and elevated the serum level of HDL-C. In the diabetic group, although there was a similarimprovement in diabetic control in both periods of placebo and Perycit treatments, there was no changein the serum levels of TG and HDL-C. There was a slight increase of the serum levels of TC in the periodsof Perycit treatment, whereas a small increase of HDL-C resulted in a mild decrease of the TC/HDL-Cratio. There was mild and transient facial flushing during the Perycit treatment in 6 out of 12 diabeticpatients. Otherwise, there was no side effects in either group．Pooling the two groups' data together,Perycit increased the serum levels of HDL-C and decreased the TC/HDL-C ratio. it is concluded thatPerycit has antilipemic effects in patients with idiopathic hyperlipidemia, and may be helpful in reducingthe atherocenic risks in these patients. In patients with hvperlipidemia superimposed with DM, althoughthe serum lipids composition was not significantly changed after Perycit , the atherogenic risks mignt alsobe reduced as demonstrated by the decrease of the TC/HDL-C ratio.
• 中文關鍵字： hyperlipidemia; diabetes mellitus; atherosclerosis; nicotinic acid derivative; niceritrol; change-over clinical trial.
• 英文關鍵字： --