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普罗布考对不稳定型心绞痛患者PCI术后的影响

邵帅,李广平,石昭昭   

  1. 天津医科大学第二医院心脏科
  • 收稿日期:2011-11-07 修回日期:2012-01-18 出版日期:2012-05-15 发布日期:2012-05-15
  • 通讯作者: 邵帅

Effect of probucol on myocardial injury, inflammation and endothelial function in patients with unstable angina pectoris underwent percutaneous coronary intervention

  • Received:2011-11-07 Revised:2012-01-18 Published:2012-05-15 Online:2012-05-15

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摘要： 摘要 目的：观察不稳定型心绞痛（unstable angina pectoris, UAP）患者经皮冠状动脉介入（percutaneous coronary intervention, PCI）治疗前后心肌损伤标记物血清肌酸激酶同工酶（CK-MB）、血浆肌钙蛋白I（cTnI）及炎症反应标记物超敏C反应蛋白（hs-CRP）以及内皮功能因子一氧化氮（NO）的水平变化，评价普罗布考对CK-MB、cTnI、hs-CRP及NO的影响，并探讨其可能的作用机制。方法：将107例UAP患者随机分为普罗布考组（52例）及对照组（55例），于PCI术前即刻及术后次日清晨6时分别检测血清CRP、NO、CK-MB及cTnI。 结果：对照组术后CRP、CK-MB、cTnI含量较同组术前明显增高（P<0.05），NO含量较同组术前明显降低（P<0.05）；普罗布考组术后CK-MB、cTnI含量较同组术前明显增高（P<0.05），CRP含量较同组术前有所增高（P>0.05），NO含量较同组术前有所降低（P>0.05）；与对照组相比，普罗布考组CRP、NO术前-术后差值明显降低（P<0.05），CK-MB、cTnI术前-术后差值有所增高（P>0.05）。 结论：UAP患者PCI术前应用普罗布考至少24小时以上，可显著减少PCI术后的炎症反应及内皮损伤，改善患者预后，但对于心肌损伤的降低并没有起到明显的作用。

关键词: 普罗布考, 不稳定型心绞痛, 经皮冠状动脉介入治疗, 心肌损伤, 炎症反应, 内皮功能

Abstract: Abstract Objective：To observe the effect of probucol on myocardial injury, inflammation and endothelial function in patients with unstable angina pectoris (UAP) underwent percutaneous coronary intervention (PCI), and investigate the probable mechanism of probucol. Methods：107 patients with UAP randomly divided into probucol group (52 cases) and control group (55 cases). Standard medical therapies were given in all 107 patients. The CK-MB, cardiac troponin I (cTnI), high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) were measured in all enrolled subjects before PCI right time and at 6:00 in the next day morning after PCI. Results：The levels of hs-CRP, CK-MB and cTnI were elevated and the level of NO was decreaed significantly after PCI in control group (P<0.05). The levels of CK-MB and cTnI were elevated significantly (P<0.05), but there were no significant changes in the increased level of hs-CRP (P>0.05) and the decreased level of NO (P>0.05) after PCI in the probucol group. However, the ascended value of hs-CRP and the descended value of NO in the probucol group were significantly lower than those in control group (P<0.05), the ascended values of CK-MB and cTnI in the probucol group were higher than those in control group (P>0.05). Conclusions：Probucol therapy in more than 24 hours before PCI can significantly reduce the inflammatory reaction and improve endothelial function and prognosis in patients with UAP, but there is no evident function on reducing myocardial injury.

Key words: probucol, unstable angina pectoris, percutaneous coronary intervention, myocardial injure, inflammation, endothelial function