普罗布考联合他汀类药物治疗对ACS患者血清脂联素、血脂水平的影响

Effect of combining treatment of probucol and statins on serum adiponectin and blood lipid profile in patients with acute coronary syndromes

目的观察单纯应用他汀类药物与普罗布考联合他汀类药物两种不同治疗方法对急性冠脉综合征患者治疗前后血清脂联素及血脂水平变化的影响。方法选择2008年10月至2009年10月住院期间确诊为急性冠脉综合征患者80例,按随机化原则分为2组:常规治疗组(40例)与联合普罗布考组(40例)。常规治疗组给予他汀类药物、抗血小板药物、硝酸酯、血管紧张素转换酶抑制剂(ACEI)及β受体阻滞剂;联合普罗布考组在上述治疗基础上加用普罗布考。2组病例均在入院后第1日和治疗1周后(入院第8天)晨起采集空腹静脉血检测脂联素、血脂。观察两种不同治疗方法对血清脂联素、血脂水平的影响。结果治疗后2组血清胆固醇、低密度脂蛋白胆固醇水平明显下降(P均<0.05),甘油三酯下降程度联合普罗布考组较常规治疗组明显(P<0.05),而2组血清胆固醇、低密度脂蛋白胆固醇水平变化值无明显差异(P均>0.05)。2组脂联素治疗后均显著升高(P均<0.05),联合普罗布考组治疗后上升幅度明显高于常规治疗组(P<0.05)。结论普罗布考联合他汀类药物治疗有益于急性冠脉综合征患者血中保护性因素脂联素的升高及血脂水平的改善,可改善预后。

Objective To investigate the effect of co-treatment of probucol and statins and statins alone on the levels of serum adiponectin and blood lipid profile in patients with acute coronary syndromes（ACS）.Methods A total of 80 patients with ACS admitted between October 2008 and October 2009 were enrolled in this study.The patients were randomly divided into two groups： conventional treatment group（40 cases） and co-treatment group（40 cases）.Conventional treatment including statins,anti-platelet drugs,nitrates,ACEI and β-receptor blockage were taken in conventional treatment group,and on the basis of conventional treatment probucol was added in co-treatment group.The fasting venous blood samples were collected at the first day and after a week for measuring lipids and adiponectin.The comparative analysis between two groups was made.Results Compared with pre-treatment,the levels of cholesterol and LDL-C after treatment were all significantly lowered in two groups（all P0.05）,while the changed value（△value） of cholesterol and LDL-C had no significant difference in two groups（all P0.05）.The lowered degree of triglyceride after treatment in the co-treatment group was more obvious than that in the conventional treatment group（P0.05）.Compared with pre-treatment,the level of adiponectin increased significantly in two groups（all P0.05）,and the △value after treatment had significant difference as well between the two groups（P0.05）.Conclusions The treatment of probucol combining with statins can markedly elevate the level of serum adiponectin and improve blood lipid profile in ACS patients,namely,increase protective factors and reduce damaging factors,therefore could improve the prognosis of ACS patients.