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目的探讨苯扎贝特对载脂蛋白(a)[LP(a)],高纤维蛋白原(FIB)及胰岛素抵抗(IR)的影响。方法临床筛选单纯高脂血症患者50例,合并2型糖尿病(NIDDM)患者50例,随机分成4组,不合并(A组)和合并(B组)NIDDM各30例为治疗组,口服苯扎贝特;另不合并(C组)和合并(D组)NIDDM各20例为对照组,口服安慰剂,疗程12周。结果A、B组经治疗后血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、LP(a)、空腹血糖(FBG)和FIB均有较明显下降、高密度脂蛋白胆固醇(HDL-C)升高,糖耐量、胰岛素抵抗改善,胰岛素敏感指数(AS指数)上升,延长PT、KPTT时间,而对照组无显著差别。结论苯扎贝特具有全面改善脂代谢紊乱的作用,同时还有改善胰岛素抵抗、降低LP(a)、FIB以及改善凝血纤溶功能。
Objective To investigate the effect of bezafibrate on apolipoprotein (a) [LP (a)], high fibrinogen (FIB) and insulin resistance (IR). Methods Fifty patients with simple hyperlipidemia and 50 patients with type 2 diabetes mellitus (NIDDM) were enrolled in the study. They were randomly divided into 4 groups, 30 cases in non-combined (group A) and combined (group B) NIDDM, Zabet; the other non-combined (group C) and combined (group D) NIDDM 20 cases for the control group, oral placebo for 12 weeks. Results The serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), LP (a), fasting blood glucose (FBG) , High density lipoprotein cholesterol (HDL-C), impaired glucose tolerance, improved insulin resistance and increased insulin sensitivity index (AS index), prolonging the PT and KPTT time. There was no significant difference in the control group. Conclusion Bezafibrate can improve the disorder of lipid metabolism, improve the insulin resistance, reduce LP (a), FIB and improve the function of coagulation and fibrinolysis.