USE OF CHOLESTYRAMINE IN THE TREATMENT OF CHILDREN WITH FAMILIAL COMBINED HYPERLIPIDEMIA

被引:23
作者
LIACOURAS, CA [1 ]
COATES, PM [1 ]
GALLAGHER, PR [1 ]
CORTNER, JA [1 ]
机构
[1] UNIV PENN, DEPT PEDIAT, PHILADELPHIA, PA 19104 USA
关键词
D O I
10.1016/S0022-3476(05)83444-4
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
We studied the effectiveness of and compliance with the use of cholestyramine in children with heterozygous familial hypercholesterolemia (FH) and familial combined hyperlipidemia (FCHL). During a 10-year period, 673 children (aged 10.5 +/- 4.0 years) were referred for evaluation of hyperlipidemia, of whom 87 (36 with FH; 51 with FCHL) were treated with cholestyramine (8 to 24 gm/day). In both groups, total cholesterol, low-density lipoprotein (LDL)-cholesterol, and apolipoprotein B levels were significantly reduced after cholestyramine use. In those with FH, plasma LDL-cholesterol levels decreased from 258 +/- 35 mg/dl (6.67 +/- 0.90 mmol/L) to 190 +/- 31 mg/dl (4.91 +/- 0.80 mmol/L); in those with FCHL, LDL-cholesterol levels dropped from 207 +/- 40 mg/dl (5.35 +/- 1.03 mmol/L) to 141 +/- 35 mg/dl (3.64 +/- 0.90 mmol/L). High-density lipoprotein-cholesterol levels were not significantly changed after cholestyramine use in either group. In the FCHL group, plasma triglyceride levels increased significantly from 81 +/- 35 mg/dl (0.92 +/- 0.40 mmol/L) to 134 +/- 42 mg/dl (1.52 +/- 0.48 mmol/L). Seven patients were lost to follow-up; 18 discontinued the medication within 1 month. Of the remaining 62 children, 59 had a good response to the drug. Of the 62 patients, 52 discontinued the medication after 21.9 +/- 10 months. Adverse effects included foul taste (73%), nausea with bloating (18%), and constipation. Cholestyramine is effective in reducing LDL-cholesterol levels in children with inherited hyperlipidemia, but the majority of children will not comply with its long-term use.
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页码:477 / 482
页数:6
相关论文
共 32 条
[1]   BILE-ACID SEQUESTRANTS [J].
AST, M ;
FRISHMAN, WH .
JOURNAL OF CLINICAL PHARMACOLOGY, 1990, 30 (02) :99-106
[2]   CHOLESTYRAMINE - EFFECTIVE, TWICE-DAILY DOSAGE REGIMEN [J].
BLUM, CB ;
HAVLIK, RJ ;
MORGANROTH, J .
ANNALS OF INTERNAL MEDICINE, 1976, 85 (03) :287-289
[3]   PREVALENCE AND EXPRESSION OF FAMILIAL COMBINED HYPERLIPIDEMIA IN CHILDHOOD [J].
CORTNER, JA ;
COATES, PM ;
GALLAGHER, PR .
JOURNAL OF PEDIATRICS, 1990, 116 (04) :514-519
[4]   FAMILIAL COMBINED HYPERLIPEMIA - USE OF STABLE ISOTOPES TO DEMONSTRATE OVERPRODUCTION OF VERY LOW-DENSITY-LIPOPROTEIN APOLIPOPROTEIN-B BY THE LIVER [J].
CORTNER, JA ;
COATES, PM ;
BENNETT, MJ ;
CRYER, DR ;
LE, NA .
JOURNAL OF INHERITED METABOLIC DISEASE, 1991, 14 (06) :915-922
[5]   PATHOGENESIS OF CORONARY DISEASE IN AMERICAN SOLDIERS KILLED IN KOREA [J].
ENOS, WF ;
BEYER, JC .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1955, 158 (11) :912-914
[6]  
FARAH JR, 1977, LANCET, V1, P59
[7]  
FRIEDEWALD WT, 1972, CLIN CHEM, V18, P499
[8]  
GLUECK CJ, 1973, PEDIATRICS, V52, P669
[9]  
GLUECK CJ, 1986, PEDIATRICS, V78, P338
[10]  
Goldstein J.L., 1989, METABOLIC BASIS INHE, P1215