目標： 探討以simvastatin 治療合併有混合型高血脂症的腎功能異常病人之效果。方法： 將病人分為兩組，第一組為腎功能異常病人，共有三十位，其中十七位正接受腎臟透析治療，其餘十三位的血清肌肝酸濃度均大於1.3 mg/dl。第二組為腎功能正常的控制組病人，共有二十位，每位血清肌肝酸濃度均小於或等於1.3 mg/dl。兩組病人均接受十六週口服simvastatin 的治療，每天口服一次，劑量為20 毫克。所有病人皆未使用其他的降血脂藥物。結果： 經過十六週治療之後，兩組病人血清中總膽固醇、三酸甘油脂及低密度脂蛋白內膽固醇濃度均顯著的降低。第一組腎功能異常病人的血清中總膽固醇由治療前258 ( 33 降至治療後199 ( 36 mg/dl；三酸甘油脂由383 ( 171 降至273 (107 mg/dl；低密度脂蛋白內膽固醇由150 ( 36 降至101 ( 33 mg/dl (p < 0.01)；而第二組腎功能正常的病人的血清中總膽固醇由262 ( 54 降至194 ( 35 mg/dl；三酸甘油脂由485 (201 降至274 ( 210 mg/dl；低密度脂蛋白內膽固醇由118 ( 41 降至101 ( 27 mg/dl (p <0.01)。兩組病人血清中高密度脂蛋白內膽固醇濃度均升高，第一組腎功能異常的病人由39 (11 升高至44( 17mg/dl ( p < 0.05)；第二組腎功能正常的病人由38 ( 8 升高至43 (10mg/dl，但統計學上無顯著意義( p= 0.064)。結論：每天以口服一次20 毫克simvastatin治療混合型高血脂症，無論是用在腎功能正常或異常的病人身上，其治療效果及安全性均極為相似。

Background and purpose: We attempted to study the efficacy of 20 mg/day simvastatinas monotherapy in patients with renal impairment combined with hyperlipidemia. Methods:Thirty patients with impaired renal function (serum creatinine of > 1.3 mg/dl, 17 of whom weredialysis patients) were studied. Twenty patients with normal renal function (serum creatinine of£ 1.3 mg/dl) were used as a control group. Once-daily 20 mg simvastatin was administered to allpatients for 16 weeks in the absence of other lipid-lowering agents. Results: Serum totalcholesterol (TC), triglycerides (TGs), and low-density lipoprotein-cholesterol (LDL-C) in bothpatient groups significantly decreased after simvastatin treatment (TC from 258 ± 33 to 199 ± 36mg/dl, TGs from 383 ± 171 to 273 ± 107 mg/dl, and LDL-C from 150 ± 36 to 101 ± 33mg/dl in patientswith impaired renal function; TC from 262 ± 54 to 194 ± 35 mg/dl, TG from 485 ± 201 to 274 ± 210mg/dl, and LDL-C from 118 ± 41 to 101 ± 27mg/dl in patientswith normal renal function, all p < 0.01).An increase in the serum high-density lipoprotein-cholesterol (HDL-C) also occurred in bothpatient groups (from 39 ± 11 to 44 ± 17 mg/dl, p < 0.05 in patients with renal impairment), however,the change in patients with normal renal function was not significant (from 38 ± 8 to 43 ± 10 mg/dl, p = 0.064). Conclusion: Monotherapy with 20 mg/day simvastatin has similar safety andeffectiveness in patients with normal and those with impaired renal function.