普罗布考对颈内动脉颅外段狭窄所致TIA患者颈动脉斑块、ox-LDL及MMP-9水平的影响

Effects of Probucol on the carotid plaque,ox-LDL,and MMP-9 levels in patients with TIA caused by external carotid artery stenosis

目的:研究普罗布考对颈内动脉颅外段狭窄所致短暂性脑缺血发作(Transient Ischemic Attack,TIA)患者的影响。方法:选取本院2020年7月至2022年12月期间91例颈内动脉颅外段狭窄所致TIA患者进行随机分组,对照组(n=45)口服瑞舒伐他汀10 mg治疗,1次·d^(-1),观察组(n=46)增加口服普罗布考0.5g·次^(-1),2次·d^(-1)。治疗4 w后,采用全自动生化分析仪检测血小板计数(Platelet count,PLT)、纤维蛋白原(Fibrinogen,FIB)、活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)、凝血酶原时间(Prothrombin Time,PT)水平;采用彩色多普勒超声检查仪于治疗前后检测颈动脉内膜中层厚度(Intima Media Thickness,IMT)、斑块面积、易损斑块数量;采用化学发光免疫法检测氧化低密度脂蛋白(Oxidized Low Density Lipoprotein,ox-LDL)、基质金属蛋白酶9(Matrix metalloproteinase 9,MMP-9)水平;记录两组腹痛、腹泻、恶心呕吐等不良反应发生情况。结果:治疗后两组APTT、FIB、PT、PLT、不良反应发生率差异不明显(P>0.05),观察组易损斑块数量、斑块面积、IMT、ox-LDL、MMP-9低于对照组(P<0.05)。结论:普罗布考能够抑制颈内动脉颅外段狭窄所致TIA患者颈动脉IMT增厚,减轻炎症反应。

Objective:To study the effects of probucol on patients with Transient Ischemic Attack(TIA)caused by extracranial stenosis of the internal carotid artery.Methods:Ninety-one patients with TIA caused by extracranial stenosis of the internal carotid artery in our hospital from July 2020 to December 2022 were randomly divided.The control group(n=45)was given rosuvastatin 10 mg orally,once a day,and the observation group(n=46)was given probucol 0.5mg orally,twice a day.After 4 weeks of treatment,platelet count(PLT),fibrinogen(FIB),activated partial thromboplastin time(APTT),and prothrombin time(PT)were detected by an automatic biochemical analyzer.Intima media thickness(IMT),plaque area,and the number of vulnerable plaques were measured by color Doppler ultrasound before and after treatment.Oxidized low-density lipoprotein(ox-LDL)and matrix metalloproteinase 9(MMP-9)were tested by chemiluminescence immunoassay.Adverse reactions such as abdominal pain,diarrhea,nausea,and vomiting were recorded in the two groups.Results:After treatment,there were no significant differences in APTT,FIB,PT,PLT,and incidence of adverse reactions between the two groups(P>0.05).The number of vulnerable plaques,plaque area,IMT,ox-LDL,and MMP-9 in the observation group were lower than those in the control group(P<0.05).Conclusion:Probucol can inhibit carotid IMT thickening and reduce inflammation in TIA patients caused by extracranial stenosis of the internal carotid artery.