普罗布考对合并糖尿病患者冠状动脉药物洗脱支架置入术后再狭窄及炎症因子的影响

Effects of probucol on drug-eluting stent restenosis and inflammation factors in coronary diseases patients with diabetes mellitus

目的评价普罗布考对合并糖尿病的冠心病患者药物洗脱支架置入术后再狭窄发生率及炎症因子的影响,初步探讨普罗布考预防再狭窄的临床价值及可能机制。方法入选72例合并糖尿病并接受药物洗脱支架置入术的冠心病患者,随机分为普罗布考组(36例)和对照组(36例)。普罗布考组在常规药物的基础上加服普罗布考(0.25 g,每日2次),连续服药至PCI术后6个月,所有患者行冠状动脉造影复查。支架内再狭窄定义为支架内或两端5 mm内出现≥50%狭窄程度的病变。测定术前及术后6个月的血清超敏C反应蛋白、白细胞介素-6、肿瘤坏死因子-α的浓度变化。结果对照组中10例(27.8%)发生再狭窄,普罗布考组仅3例(8.3%)发生再狭窄,两组间比较,差异有统计学意义(P=0.032);术后6个月时两组患者炎症因子水平较术前均有下降,普罗布考组下降更显著,差异具有统计学意义(P<0.05)。结论普罗布考能够有效降低合并糖尿病的冠心病患者置入药物洗脱支架置入后再狭窄的发生,其机制可能与抗炎作用有关。

Objective To evaluate the effects of probucol on drug-eluting stent restenosis and inflammation factors in coronary artery diseases patients with diabetes mellitus. Methods Seventy-two CAD patients with diabetes mellitus and received coronary drug-eluting stents implantation were randomly divided into probucol group（ n = 36） and control group（ n = 36）. All patients accepted angiography follow-up 6months later. Stent restenosis was defined as luminal stenosis of ≥50% within the stent or within 5 mm of the stent edges. High-sensitivity C-reactive protein,interleukin-6 and tumor necrosis factor-α before and after the procedures were checked and analyzed. Results All patients completed the follow up,and accepted the 6-month angiography exam. There were no significant differences in terms of age,sex,risk factors,coronary lesion,and stent number. Stent restenosis occurred in 10 patients in the control group and only 3 patients in the probucol group（ P = 0. 032）. There was no significant difference in terms of baseline serum levels of high-sensitivity C-reactive protein, interleukin-6 and tumor necrosis factor-α. The inflammation factors deceased significantly in the probucol group after 6 months treatment（ P 〈 0. 05）.Conclusions Probucol could inhibit stent restenosis rate after coronary intervention in patients with diabetes mellitus and decrease serum concentrations of inflammation factors.