普罗布考联合他汀对冠心病患者氧化低密度脂蛋白胆固醇和高敏C反应蛋白的影响

Effect of probucol in combination with statin on oxidated low density lipoprotein and high sensitive C reactive protein in patients with coronary heart disease

目的观察急性冠脉综合征(ACS)患者普罗布考联合他汀治疗组和单纯他汀组对氧化低密度脂蛋白(Ox-LDL)和高敏C反应蛋白(Hs-CRP)水平的影响。方法选取2009年1月-2010年6月在我院心内科住院确诊急性冠脉综合征患者住院期间随机分为联合组和单纯组,两组均常规使用硝酸脂和抗血小板药物,联合组普罗布考0.75mg/d,2次/d;阿托伐他汀20mg/d,每晚1次。单纯组他汀用量及用法同联合组。随访3个月后测定Ox-LDL和Hs-CRP的表达,并进行两者的相关性分析。结果治疗后联合组的Ox-LDL和Hs-CRP较单纯他汀组含量明显降低,分别为(409.3±42.1)μg/L比(487.2±65.2)μg/L,P<0.01;(3.28±1.11)mg/L比(3.93±1.76)mg/L,P<0.01。联合组和单纯治疗组患者血清Ox-LDL和Hs-CRP均呈显著正相关(r=0.773,P<0.01;r=0.724,P<0.01)。结论两组冠心病患者中Ox-LDL和Hs-CRP均存在较高的正相关,普罗布考联合他汀较单纯他汀治疗更能降低Ox-LDL和CRP的表达,提示普罗布考能够发挥较强大的抗动脉粥样硬化作用。

Objective To observe the effect of probucol in combination with statin on oxidated low density lipoprotein（Ox-LDL） and high sensitive C reactive protein（Hs-CRP） in patients with coronary heart disease.Methods Patients with acute coronary syndrome admitted to Department of Cardiology in our hospital from January 2009 to June 2010 were randomly divided into combined probucol and statin treatment group and simple statin treatment group.Patients in combined probucol and statin treatment group were treated with 0.75mg probucol（twice a day） and 20mg statin（once a day） plus nitrate esters and anti-platelet drugs.Patients in simple statin treatment group were treated with 20mg statin（once a day） plus nitrate esters and anti-platelet drugs.The patients were followed up for three months during which expressions of Ox-LDL and Hs-CRP were detected and their correlation was analyzed.Results The Ox-LDL and Hs-CRP expression levels were lower in combined probucol and statin treatment group than in simple statin treatment group（409.3±42.1μg/L vs 487.2±65.2μg/L,and 3.28±1.11mg/L vs 3.93±1.76mg/L,P0.01）.The serum Ox-LDL and CRP in both groups were positively correlated（r=0.773,r=0.724,P0.01）.Conclusion Ox-LDL and Hs-CRP are highly correlated in patients with coronary heart disease.Probucol in combination with statin can reduce the expression of Ox-LDL and Hs-CRP more significantly than statin alone in patients with coronary heart disease,indicating that probucol plays a more important role in anti-atherosclerosis than statin.