普罗布考联合阿托伐他汀对急性冠脉综合征血脂蛋白相关磷脂酶A2的影响

Effect of Probucol Combined with Atorvastatin on Plasma Level of Lipoprotein-Associated phospholipase A2 in Patients with Acute Coronary Syndrome

目的：评价普罗布考和阿托伐他汀联合应用对急性冠脉综合征（ACS）患者血脂及脂蛋白相关磷脂酶A2（Lp-PLA2）的影响。方法：将94例经冠脉造影证实的ACS患者随机分为2组：单药组48例，予以阿托伐他汀（20mg／d）治疗；联合组46例，予以阿托伐他汀（20mg／d）和普罗布考（500mg／d）联合治疗。分别于治疗前和治疗后6-8周检测血Lp-PLA2和血总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平并进行比较分析。结果：2组治疗前TC、TG、LDL-C、HDL-C、Lp-PLA2水平比较差异无统计学意义（P〉0．05）；2组治疗后TC、TG、LDL-C、Lp-PLA2较治疗前均降低，单药组治疗后HDL-C升高，联合组治疗后HDL-C下降，差异均有统计学意义（P〈0．01）；联合组较单独治疗组治疗后TC、LDL-C、Lp-PLA2降低，差异均有统计学意义（P〈0．05），但TG差异无统计学意义（P〉0．05）。结论：对ACS患者单独应用阿托伐他汀及联合普罗布考均能够有效降低TC、LDL-C、Lp-PLA2，但联合治疗疗效更为显著，对稳定斑块、抗动脉粥样硬化有重要意义。

Objective： To evaluate the effect of probucol and atorvastatin combined medication on blood levels of liquids and Lipoprotein-associated phospholipase A2 （Lp-PLA2） in patients with acute coronary syndrome（ACS）. Methods： A total of 94 pa- tients with ACS diagnosed by coronary angiography （CAG） were randomly divided into two groups： single medication group （n=48） and combined medication group （n=46）. Patients were given atorvastatin 20 mg/d or atorvastatin 20 mg/d with probucol 500 mg/d in two groups of patients. The plasma levels of Lp-PLA2, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein-cholesterol （LDL-C） and high density lipoprotein-cholesterol （HDL-C） were detected and compared before and 6-8 weeks after the medication two groups of patients. Results： There were no significant differences in levels of TC,TG,LDL-C,HDL-C and Lp-PLA2 before treat- ment between two groups of patients（P 〉 0.05）. The values of TC, TG, LDL-C and Lp-PLA2 were significantly decreased after the treatment in patients of beth two groups （P 〈 0.01）. There was a increased level of HDL-C in patients of single medication group. But, the level of HDL-C significantly decreased in patients of combined medication group （P 〈 0.01）. Compared with single medica- tion group the values of TC, LDL-C and Lp-PLA2 were significantly decreased in the combined medication group （P 〈 0.05）, but no significant difference in the level of TG between two groups of patients（P 〉 0.05）. Conclusion： The values of TC, LDL-C and Lp-PLA2 can be decreased by single atorvastatin medication or probucol and atorvastatin combined medication, but there was more significant effect by combined medication in ACS patients. The combined treatment plays an important role in stabilizing the plaques and anti-atherosclerosis in ACS patients.