普罗布考联合阿托伐他汀对急性冠脉综合征患者妊娠相关血浆蛋白和高敏C反应蛋白的影响

The effect of probucol and atorvastatin combination on PAPP-A and hs-CRP level in patients with acute coronary syndrome

目的比较急性冠脉综合征(ACS)患者早期使用普罗布考联合阿托伐他汀与单用阿托伐他汀对妊娠相关血浆蛋白A(PAPP-A)及高敏C反应蛋白(hs-CRP)的影响。方法将90例ACS患者随机分为单独治疗组(阿托伐他汀20mg/d)和联合治疗组(普罗布考1g/d,阿托伐他汀20mg/d)。分别测量两组患者服药前和服药1个月时的血清PAPP-A、hs-CR水平。结果单独治疗组治疗前血清PAPP-A和hs-CRP水平分别为(2.09±0.69)mIU/L和(4.17±2.93)mg/L,治疗后降至(1.68±0.40)mIU/L和(2.33±2.25)mg/L。联合治疗组治疗前血清PAPP-A和hs-CRP水平分别为(2.25±0.64)mIU/L和(5.18±4.56)mg/L,治疗后降至(1.54±0.38)mIU/L和(1.60±1.11)mg/L。两组患者治疗后血清PAPP-A和hs-CRP水平较治疗前均明显降低(P<0.01),但联合治疗组降低的幅度较单独治疗组大(P<0.05)。多因素直线相关分析显示ACS患者的血清PAPP-A与hs-CRP显著相关(r=0.378,P<0.01)。结论短期使用普罗布考联合阿托伐他汀与单用阿托伐他汀均能降低ACS患者血清PAPP-A与hs-CRP水平,可能起到抑制炎症反应、稳定冠状动脉粥样斑块的作用。加用普罗布考可能发挥进一步稳定斑块的作用。

Objective To investigate the effects of probucol combined with atorvastatin and atorvastatin only on serum pregnancy-associated plasma protein-A （PAPP-A） and high-sensitivity C-reactive protein （hs-CRP） levels after 1 month. Methods Ninety patients with ACS were assigned to atorvastatin only group （20mg/d of atorvastain, n-49） or combined therapeutic group （20mg/d of atorvastain and 1.0g/d of prohucol, n=41） in a randomized, controlled study. Serum levels of PAPP-A and hs-CRP were detected before and after treatment. Results The levels of PAPP-A and hs-CRP in atorvastain only group before treatment were （2.09±0.69）mIU/L and （4.17±2.93）mg/L respectively, which decreased to （1.68± 0.40）mIU/L and （2.33±2.25）mg/L after treatment. In the combined treatment group, they were （2.25±0.64）mIU/L and （5.18± 4.56）mg/L respectively before treatment and （1.54±0.38）mIU/L and （1.60±1.11）mg/L respectively after treatment. After treated with atorvastain only and cobined therapy the levels of serum PAPP-A and hs-CRP were significantly decreased（P 〈 0.01）, and those in combined therapy decreased even more markedly（P〈 0.05）. Conclusions Both atorvastain alone and atorvastain combined probucol can decrease the levels of PAPP-A and hs-CRP in patients with ACS, which may reduce inflammatory reaction and stabilize plaque. Atorvastain combined with prohucol may have stronger effect on stabilizing plaque than atorvastain alone.