普罗布考对急性脑梗死患者临床及血管内皮功能的影响

Effect of probucol on the functional outcome and vascular endothelial function in patients with acute cerebral infarction

目的:观察普罗布考对急性脑梗死患者临床及血管内皮功能的影响。方法:100例急性脑梗死患者按入院顺序随机分为普罗布考组54例和对照组46例。对照组用常规治疗方法治疗,包括溶栓、抗血小板聚集(阿司匹林100 mg.d-1)治疗、处理并发症及基础疾病等。普罗布考组在常规治疗的基础上加服普罗布考0.5 g,bid。2组均连续治疗6个月。于治疗前和治疗1,6个月后进行神经功能缺损评分的评估,治疗前和治疗6个月后检测血脂和血管内皮功能指标的变化情况。结果:治疗1,6个月后,普罗布考组神经功能缺损评分比治疗前均显著降低(P<0.01),比对照组均显著降低(P<0.01);用药6个月后普罗布考组血脂、血ET-1及ox-LDL比对照组显著降低(P<0.01或P<0.05);普罗布考组NO及FMD比治疗前显著升高(P<0.05)。对照组血NO,ET-1,ox-LDL及FMD治疗前后差异无统计学意义(P>0.05)。普罗布考组未发现严重的不良反应。结论:普罗布考能显著地改善神经功能,调整血脂代谢,改善血管内皮功能,且安全性好。

Objective： To observe the effect of probucol on the functional outcome and vascular endothelial function in patients with acute cerebral infarction.Methods： A total of 100 patients with acute cerebral infarction were randomly divided into 2 groups.The patients in control group（n=46） were treated with conventional therapy for 6 months,including thrombolysis,anti-platelet aggregation（aspirin 100 mg·d^-1）,decreasing intracranial pressure,and treating complications and basic diseases.The patients in probucol group（n=54） were treated for 6 months with probucol 0.5 g,twice a day,in addition to conventional therapy.Neurological deficit score was assessed at 1 and 6 months.The serum lipids and indicators of vascular endothelial function were detected before treatment and 6 months after treatment.Results： At 1 and 6 months,the neurological deficit scores were significantly reduced after treatment with probucol（P〈0.01）,and significantly lower than that in control group（P〈0.01）.At 6 months,the lipids,blood ET-1 and ox-LDL were significantly lower in probucol group than in control group（P〈0.01 or P〈0.05）.NO and FMD levels were significantly increased after treatment with probucol（P〈0.05）.Blood NO,ET-1,ox-LDL and FMD showed no significant differences before and after treatment（P〉0.05）.No serious adverse reactions were found in probucol group.Conclusion： Probucol significantly improves the neurological function,the lipid metabolism,and endothelial function with a better safety.