普罗布考联合阿托伐他汀对脑梗死颈动脉粥样硬化斑块稳定性的影响  

Effects of Probucol Combined with Atorvastatin on Carotid Atherosclerosis of Cerebral Infarction Patients

作　　者：赵晓晖[1] 周媛[1] 陈翠荣[1] 白青科[1] 沈健[1] 陆练军[1] 陈娟[1] 杨娟[1] 朱玉萍[1] 

机构地区：[1]上海市浦东新区人民医院神经内科,上海市201200

出　　处：《中国动脉硬化杂志》2010年第5期380-384,共5页Chinese Journal of Arteriosclerosis

基　　金：上海市卫生局科研课题计划资助(2007124)

摘　　要：目的探讨普罗布考联合阿托伐他汀治疗对脑梗死颈动脉粥样硬化的干预作用。方法急性脑梗死患者120例,入院查颈动脉彩超提示存在动脉粥样硬化斑块,其中男68例,女52例,年龄74±15岁,随机分为两组:阿托伐他汀组男35例,女25例,年龄73±16岁,予阿托伐他汀(20 mg/d)治疗;联合治疗组男33例,女27例,年龄76±18岁,予阿托伐他汀(20 mg/d)和普罗布考(500 mg/d)联合治疗。两组患者分别于治疗前、治疗后6个月、12个月及24个月检测血清脂蛋白相关性磷脂酶A2活性、颈动脉粥样硬化斑块情况,并进行分组分析。结果阿托伐他汀组和联合治疗组治疗前脂蛋白相关性磷脂酶A2活性分别为18.43±8.01 mmol/(min.L)和18.65±8.12 mmol/(min.L),无显著性差异;治疗6个月脂蛋白相关性磷脂酶A2活性分别为14.98±4.21 mmol/(min.L)和12.68±2.04 mmol/(min.L),明显下降,联合治疗组下降更显著;治疗12个月两组脂蛋白相关性磷脂酶A2活性分别为11.57±1.62 mmol/(min.L)和11.98±1.43 mmol/(min.L),进一步明显下降;治疗24个月脂蛋白相关性磷脂酶A2活性分别为12.06±1.68 mmol/(min.L)和11.34±1.61 mmol/(min.L),继续保持12个月时水平,但联合治疗组较阿托伐他汀组下降更明显(P<0.05)。阿托伐他汀组治疗前、治疗后6个月、12个月及24个月稳定性斑块积分分别为2.73±0.31、2.68±0.46、3.92±0.28及3.84±0.35,6个月时积分有所减少,但无统计学意义,12个月、24个月时积分较前两时间点明显增高(P<0.05);不稳定性斑块积分分别为6.82±0.37、4.38±0.42、3.02±0.43、3.28±0.29,6个月时积分较治疗前明显减少(P<0.05),且12个月、24个月时积分进一步较少(P<0.01)。联合治疗组治疗前、治疗后6个月、12个月及24个月稳定性斑块积分分别为2.68±0.34、2.73±0.50、3.01±0.44及2.89±0.42,各时间点间无显著性差异;不稳定性斑块积分分别为7.08±0.39、4.92±0.33、3.11±0.46及2.28±0.41,各时间点间均有显著性�Aim To explore the effects of probucol combined with atorvastatin on carotid atherosclerosis of cerebral infarction patients. Methods 120 acute cerebral infarction patients included 68 males and 52 females,whose average age were 74±15 years.They all had atherosclerosis plaques detected by carotid artery ultrasonography.All subjects were divided randomly into 2 groups： atorvastatin group were treated with atorvastatin（20 mg/d） which included 35 males and 25 females,whose average age were 73±16 years;combined treatment group were treated with atrovastatin（20 mg/d） combined with probucol（500 mg/d） which included 33 males and 27 females,whose average age were 76±18 yeares.The lipoprotein-associated phospholipase A2（Lp-PLA2） activities in serum,characters of carotid atherosclerosis plaques of the two groups were assayed before treatment,6 month,12 month and 24 month after treatment. Results Lp-PLA2 activities in the two groups pretreatment were 18.43±8.01（mmol/（min.L）） and 18.65±8.12（mmol/（min.L）） respectively and there were no significant difference in the two groups.It decreased distinctly to 14.98±4.21（mmol/（min.L）） and 12.68±2.04（mmol/（min.L）） 6 month after treatment in the two groups,especially in com-bined treatment group;and it decreased further to 11.57±1.62（mmol/（min.L）） and 11.98±1.43（mmol/（min.L）） respectively 12 months after treatment and kept on the comparable level as 12 month on the 24 month time point：12.06±1.68（mmol/（min.L）） and 11.34±1.61（mmol/（min.L））.The magnitude of varieties in atorvastatingroup was much larger than that in combined treatment group（P0.05）.In atorvastatin group the average integral ofstable plaques were 2.73±0.31,2.68±0.46,3.92±0.28 and 3.84±0.35 respectivly on pretreatment,6 month,12month and 24 month time point after treatment.The average integral on the 6 month time point dropped compared withpretreatment but had no significant difference.The average integral on 12 month and 2

关 键 词：脑梗死 普罗布考 阿托伐他汀 颈动脉粥样斑块 脂蛋白相关性磷脂酶A2 

分 类 号：R5[医药卫生—内科学]