普罗布考联合阿托伐他汀对高密度脂蛋白亚型和甘油三酯水平的影响

Effects of probucol combined with atorvastatin on the levels of high density lipoprotein subfractions and triglyceride

目的探讨普罗布考联合阿托伐他汀对急性冠状动脉综合征合并2型糖尿病惠者HDL-C亚型和TG水平的影响。方法选取急性冠状动脉综合征合并2型糖尿病患者120例,随机分为治疗组和对照组各60例,治疗组给予普罗布考500 mg,2次/d;阿托伐他汀20 mg,1次/晚;对照组给予阿托伐他汀20 mg,1次/晚。2组均常规使用硝酸酯类和抗血小板药物。治疗前及治疗3个月后分别检测TG、TC、LDL-C、HDL-C、HDL_2、HDL_3。结果与治疗前比较,治疗3个月后,2组患者TG、TC、LDL-C均有下降(P<0.05),治疗组下降更为明显(P<0.01),治疗组患者HDL-C和HDL_2明显下降,HDL_3、HDL_3/HDL-C明显升高(P<0.05),对照组HDLC明显升高(P<0.05)。与对照组治疗后比较,治疗组TG、TC、LDL-C、HDL-C、HDL_2明显下降(P<0.05),HDL_3、HDL_3/HDL-C明显升高(P<0.05)。结论普罗布考联合阿托伐他汀治疗急性冠状动脉综合征合并2型糖尿病,可更好降低TG、TC、LDL-C,虽然同时HDL-C总量有所下降,但逆向转运TC能力更强的HDL_3却增加。

Objective To probe the impact of probucol combined with atorvastatin on the levels of HDL-C subfractions and TG in ACS patients with type-2 diabetes. Methods 120 patients with ACS and type-2 diabetes were divided randomly into a treatment group and a control group of 60 cases each. The treatment group was treated with probucol 500 mg, bid,atorvastatin 20 mg, qn; the control group was treated with atorvastatin 20 mg, qn. Nitrate esters and antiplatelet drugs were used in both groups. At the beginning of the treatment and after three months of treatment, the patients＇ TG,TC,LDL-C,HDL-C, HDL2 and HDL3 were examined. Results Compared with before treatment,TG,TC and LDL-C of both groups decreased after three months of treatment （P 〈 0.05） ,the treatment group decreased more significantly （P 〈 0.01）, HDL-C and HDL2 of the treatment group decreased significantly （P 〈 0.05） ,HDL3 and HDL3/HDL-C increased obviously （P 〈0.05）. HDL-C of the control group increased significantly （P〈 0.05）. Compared with the control group after treatment, TG,TC, LDL-C, HDL-C and HDL2 decreased more significantly （P 〈0.05）, HDLa and HDL3/HDL-C increased more significantly in the treatment group （P 〈0.05）. Conclusion Patients with ACS and type-2 diabetes treated with probucol combined with atorvastatin can reduce TG, TC and LDL-C, at the same time, although total HDL declines, HDLa with the ability of reverse transportation of TC increases.