普罗布考联合阿托伐他汀对ACS患者PCI术后ox-LDL及Lp-PLA2水平的影响  

The influence of probucol combined with atorvastatin on plasma levels of oxidative low density lipoprotein and lipoprotein-associated phospholipase A2 in patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：杨丽[1,2] 刘寅[2] 王树峰[2] 刘婷[2] 郭胜利[3] 

机构地区：[1]天津医科大学胸科临床学院,300222 [2]天津市胸科医院 [3]天津市急救中心

出　　处：《天津医药》2017年第1期47-50,共4页Tianjin Medical Journal

基　　金：天津市卫生局科技基金项目(2011KZ63);天津市科技计划项目(16YFZCSY00800)

摘　　要：目的观察急性冠脉综合征(ACS)行冠状动脉介入治疗(PCI)术的患者联合应用普罗布考和阿托伐他汀治疗后,循环中氧化型低密度脂蛋白(ox-LDL)及脂蛋白相关磷脂酶A2(Lp-PLA2)水平的变化及其相互关系。方法97例行PCI的ACS患者依据入院日期分为单药组(42例,单日入院者)和联合组(55例,双日入院者)。在常规治疗基础上,单药组予以阿托伐他汀(20 mg/次,1次/d)治疗;联合组在单药组基础上再予以普罗布考(250 mg/次,2次/d)联合治疗,分别于治疗前及治疗后6~8周采用酶联免疫吸附试验(ELISA)检测血Lp-PLA2、ox-LDL水平,分别进行组间比较及治疗前后比较。结果 (1)2组治疗前ox-LDL、Lp-PLA2水平差异无统计学意义。联合组治疗后ox-LDL水平较治疗前下降(P<0.01)。2组治疗后Lp-PLA2水平均较治疗前下降,治疗后联合组ox-LDL和Lp-PLA2水平均低于单药组(P<0.01)。(2)联合组患者治疗前后Lp-PLA2的下降绝对值(ΔLp-PLA2)与ox-LDL的下降绝对值(Δox-LDL)呈正相关(r=0.314,P=0.020)。结论普罗布考联合阿托伐他汀治疗能有效降低ACS患者ox-LDL和Lp-PLA2水平,并且二者的下降幅度呈正相关,普罗布考通过抑制ox-LDL的生成进一步降低Lp-PLA2水平可能是其抗动脉粥样硬化的机制之一。Objective To evaluate the effects of probucol combined with atorvastatin medication on blood levels ofoxidized low-density lipoprotein（ox-LDL）, lipoprotein-associated phospholipase A2（Lp-PLA2）, and the correlation of theirchanges in patients with acute coronary syndrome（ACS） undergoing percutaneous poronary intervention（PCI）. Methods Atotal of 97 patients with ACS and undergoing PCI were randomly divided into two groups according to the date of admission：single medication group（n=42）,the patients were taken atorvastatin 20 mg/d; and combined medication group（n=55）,thepatients were taken atorvastatin 20 mg/d with probucol 500 mg/d. The plasma levels of ox- LDL and Lp- PLA2 weremeasured in both groups before and 6-8 weeks after the medication. Then the results were compared and analyzed betweentwo groups. Results（1） Before treatment there were no significant differences in levels of ox-LDL and Lp-PLA2 betweentwo groups（P 〉 0.05）. After the treatment, the ox-LDL level was significantly decreased in combined medication group（P 〈0.01）. After the treatment, the levels of Lp-PLA2 were significantly decreased than those before treatment in both groups（P 〈 0.01）. Compared with single medication group, levels of ox-LDL and Lp-PLA2 were significantly lower in combinedmedication group（P 〈 0.01）.（2） After treatment, the absolute value of Lp- PLA2 decline（ΔLp- PLA2） was positivelycorrelated with the absolute value of ox- LDL decline（Δox- LDL） in combined medication group（r=0.314, P=0.020）.Conclusion Probucol combined with statin therapy can reduce ox- LDL and Lp- PLA2 levels, and with a positivecorrelation between them. Probucol can further decrease the level of Lp-PLA2 by inhibiting ox-LDL production, which may be one of the mechanisms of its anti-atherosclerosis.

关 键 词：急性冠状动脉综合征 磷脂酶A2 氧化型低密度脂蛋白 普罗布考 阿托伐他汀 抗氧化 

分 类 号：R541.4[医药卫生—心血管疾病]