天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (1): 47-50.doi: 10.11958/20161058

• 临床研究 • 上一篇    下一篇

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 #br#

1 天津医科大学胸科临床学院 （邮编 300222）； 2 天津市胸科医院； 3 天津市急救中心 #br# #br#   

  1. 1 天津医科大学胸科临床学院 （邮编 300222）； 2 天津市胸科医院； 3 天津市急救中心
  • 收稿日期:2016-09-27 修回日期:2016-11-16 出版日期:2017-01-15 发布日期:2017-01-15
  • 通讯作者: 刘寅 E-mail:liuyin2088@163.com

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

YANG Li1， 2， LIU Yin2，WANG Shu-feng2， LIU Ting2， GUO Sheng-li3△   

  1. 1 Thoracic Clinical College, Tianjin Medical University, Tianjin 300222, China； 2 Tianjin Chest Hospital; 3 Tianjin Emergency Center
  • Received:2016-09-27 Revised:2016-11-16 Published:2017-01-15 Online:2017-01-15

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摘要： 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 LpPLA2 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 oxLDL 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。

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

Abstract: gsl@163.com Abstract：Objective To evaluate the effects of probucol combined with atorvastatin medication on blood levels of oxidized low-density lipoprotein (ox-LDL), lipoprotein-associated phospholipase A2 (Lp-PLA2), and the correlation of their changes in patients with acute coronary syndrome (ACS) undergoing percutaneous poronary intervention (PCI). Methods A total 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)， the patients were taken atorvastatin 20 mg/d with probucol 500 mg/d. The plasma levels of ox- LDL and Lp- PLA2 were measured in both groups before and 6-8 weeks after the medication. Then the results were compared and analyzed between two groups. Results (1) Before treatment there were no significant differences in levels of ox-LDL and Lp-PLA2 between two 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 combined medication group (P < 0.01). (2) After treatment, the absolute value of Lp- PLA2 decline (ΔLp- PLA2) was positively correlated 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 positive correlation 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.

Key words: acute coronary syndrome, phospholipases A2, oxidative low density lipoprotein, Probucol, atorvastatin, antioxidant