普罗布考对冠心病患者氧化还原态失衡的影响

Remedy of redox status imbalance with probucol in patients with coronary heart disease

目的探讨普罗布考和考来烯胺对冠心病患者疗效及对氧化还原态失衡的影响。方法纳入冠心病伴高胆固醇血症患者221例,随机分为普罗布考组(n=112)和考来烯胺组(n=109),测定两组治疗前及治疗后8周总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、一氧化氮(NO)、内皮素-1(ET-1)、还原型谷胱甘肽(GSH)和氧化型谷胱甘肽(GSSG)水平,计算还原型谷胱甘肽/氧化型谷胱甘肽(GSH/GSSG)的氧化还原电位;观察两组患者的临床疗效和心电图的差异,并评价其与氧化还原状态的关系。结果冠心病患者经普罗布考和考来烯胺降脂治疗8周后,两组患者TC、LDL-C下降程度接近,但普罗布考组GSH、GSH/GSSG比值显著升高(P<0.01),GSSG及GSH/GSSG氧化还原电位显著减低(P<0.05);ET-1明显降低(P<0.05),NO及NO/ET-1比值明显升高(P<0.01);普罗布考组心绞痛治疗总有效率及心电图改善率优于考来烯胺组(分别为77.1%vs.66.7%和75.0%vs.64.5%,P<0.05)。结论普罗布考与考来烯胺降脂作用接近,但更有利于氧化状态的改善,在改善冠心病综合症状及血管内皮功能方面优于考来烯胺。

Objective To discuss the difference in curative effects of probucol and cholestyramine on coronary heart disease （ CHD ） and vascular endothelial function. Methods The patients with CHD complicating hypercholesteremia （ n =221 ） were randomly divided into probucol group （ n =112 ） and cholestyramine group （ n =109 ） . The levels of total cholesterol （ TC ） , triglyceride （ TG ） , low-density lipoprotein-cholesterol （ LDL-C ） , nitric oxide （ NO ） , endothelin-1 （ ET-1 ） , reduced glutathione （ GSH ） and oxidized glutathione （ GSSG ） were detected 8 weeks before and after treatment. The redox potential of GSH/GSSG was calculated and the curative effect and improvement of electrocardiogram （ ECG ） were observed in the patients of two groups. Results After the treatment for 8 weeks, two groups had similar reducing effect in the levels of TC and LDL-C, but in probucol group GSH and ratio of GSH/GSSG increased significantly （ P 0.01 ） , redox potential of GSSG and GSH/GSSG decreased significantly （ P 0.05 ） , ET-1 decreased significantly （ P 0.05 ） and NO and ratio of NO/ET-1 increased significantly （ P 0.01 ） . The total effective rate on angina and improving rate of ECG were superior in probucol group to those in cholestyramine group （ 77.1 % vs. 66.7%, 75.0% vs. 64.5%, P 0.05 ） . Conclusion Probucol and cholestyramine have the similar lipid-reducing effect, and probucol is better than cholestyramine in relieving CHD comprehensive symptoms and improving vascular endothelial function