老年下肢动脉硬化症患者氧化低密度脂蛋白与内皮功能的关系及普罗布考的干预研究

Relationship between plasma ox-LDL level and endothelial function of the lower-extremity atherosclerotic disease in the elderly and an intervention study with probucol

目的评价老年下肢动脉硬化症(LEASD)患者血清氧化低密度脂蛋白(oxLDL)水平与内皮舒张功能的关系,同时评估普罗布考对oxLDL水平与内皮舒张功能的影响。方法采用随机、开放、自身对照和组间对照,将54例老年LEASD患者分为两组,其中1组为普罗布考组(33例)服用普罗布考0.5g,2次d,同时服用常规抗血小板药物(阿司匹林100mg,1次d);对照组(21例)仅服用阿司匹林(100mg,1次d),疗程均为12周。分别于服药前后检测血清oxLDL水平,同时采用高分辨率超声技术,对治疗前后血管内皮舒张功能进行检测。结果治疗前,所有患者内皮依赖舒张功能(FMD)与其oxLDL水平未呈现出线性关系;治疗后,普罗布考组FMD明显增加,血清oxLDL水平显著降低;治疗后血清oxLDL水平与FMD呈现出线性关系。结论普罗布考能够改善老年LEASD患者内皮功能,并能显著降低血清oxLDL水平;普罗布考组患者内皮功能改善与其oxLDL水平的降低有关。

Objective To evaluate the relationship between plasma ox-LDL level and endothelial relaxing function of the lower-extremity atherosclerotic disease （LEASD） in the elderly and the effect of probucol on the plasma ox-LDL level and endothelial relaxing function. Methods Fifty-four patients with LEASD were randomly divided into treatment group, including 33 subjects who received probucol O. 5g, bid with regular antithrombotic therapeutics （aspirin 100 mg, qd）, and control group, including 21 subjects who received only aspirin 100 mg, qd. The total period of treatment was 12 weeks. The plasma ox-LDL levels before and after treatment were measured. The flow-mediated （endothelium-dependent） dilation （FMD） and nitroglycerin-mediated dilation （NMD） before and after treatment were measured with color Doppler ultrasonograph. Results Before treatment, there was no linear correlation between the plasma ox-LDL level and endothelial relaxing function. After treatment, FMD in treatment group was significantly improved and had linear correlation with plasma ox-LDL level which was significantly decreased. Conclusions Probucol could improve the endothelial relaxing function of the LEASD in the elderly and significandy reduce the plasma ox-LDL level. Improvement of endothelial relaxing function in treatment group was related to the reduction of plasma ox-LDL level.