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口服维甲酸类最重要的副作用是致畸性和对血脂的影响。前者包括对中枢神经系统、心脏、胸腺和颅面的影响,可累及其中任何一个或多个系统;后者主要限于血浆甘油三酯(PT)水平的升高和高密度脂蛋白胆固醇(HDLC)的降低。脂质效应:口服13-顺维甲酸1mg/kg/d 或更高剂量,大约25%的病人 PT 水平升高大于10%或更高。PT 的升高经常地但不是必然地伴有血清胆固醇和低密度脂蛋白胆固醇的升高,以及 HDLC 的降低。服用依曲替酯的病人也可有类似的变化。维甲酸类对载脂蛋白 A I、高密度脂蛋白磷脂、脂蛋白酯酶和肝甘油三酯酯酶无明显影响。通常,糖尿病、肥胖、疗前高甘油三酯血症和大量饮酒者,维甲酸类治疗伴发 PT 升高的危险性更大,因此,在用
The most important side effects of oral retinoids are teratogenicity and the effects on blood lipids. The former includes effects on the central nervous system, heart, thymus and craniofacial area and may involve any one or more of these systems; the latter is mainly limited to elevated plasma triglyceride (PT) levels and high density lipoprotein cholesterol (HDLC) The reduction. Lipid effects: A dose of 1 mg / kg / day or more of 13-cistrinoate orally, with PT levels increased by more than 10% or more in about 25% of patients. Increased PT is often, but not necessarily, accompanied by an increase in serum cholesterol and low density lipoprotein cholesterol, and a decrease in HDLC. Patients taking onotetra may also have similar changes. Retinoids had no significant effect on apolipoprotein AI, HDL, lipoprotein lipase and hepatic triglyceride esterase. Often diabetes, obesity, pretreatment hypertriglyceridemia, and heavy drinkers are more at risk of retinoid uptake associated with PT. Therefore,