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普罗布考对高血压合并脑梗死患者氧化型低密度脂蛋白水平的影响*

夏晓爽1,李新2,王林1,王纪佐2   

  1. 1. 天津医科大学第二医院
    2. 天津医科大学第二医院神经内科
  • 收稿日期:2012-09-12 修回日期:2012-11-24 出版日期:2013-05-15 发布日期:2013-05-15
  • 通讯作者: 夏晓爽

Study on Plasma Oxidized Low-density Lipoprotein Levels in Patients with Acute Cerebral Infarction and the Effect of Supplement Therapy with Probucol

  • Received:2012-09-12 Revised:2012-11-24 Published:2013-05-15 Online:2013-05-15
  • Contact: XIA Xiaoshuang

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摘要：

【摘要】 目的  探讨急性脑梗死患者氧化型低密度脂蛋白(ox-LDL)水平的特点及ox-LDL致脑梗死的发病机制,评价普罗布考对ox-LDL及血管功能的改善作用。方法 120例急性脑梗死患者根据是否合并高血压分为血压正常组和合并高血压组各60例,再将2个病例组分别随机分为干预组和未干预组,每组30例,干预组患者在常规治疗的基础上加用普罗布考治疗,所有患者分别于治疗前,治疗后2周、12周检测ox-LDL、内皮型一氧化氮合酶(eNOS)及NO水平。结果 脑梗死合并高血压组的ox-LDL高于正常血压组,eNOS、NO水平低于正常血压组。对于脑梗死正常血压患者,普罗布考干预治疗12周后,TC、HDL、ox-LDL水平降低,eNOS升高(P<0.05)。对于脑梗死合并高血压患者,普罗布考干预治疗12周后,TC、TG、LDL、ox-LDL水平降低,eNOS、NO升高(P<0.05)。结论  普罗布考除具有调脂作用外,还可降低ox-LDL水平,改善血管内皮功能,稳定斑块,有利于防止发生动脉粥样硬化。

关键词: 普罗布考, 脑梗死, 高血压, 脂蛋白类, LDL, 一氧化氮合酶, 一氧化氮, 氧化型低密度脂蛋白

Abstract: [Abstract] Objective   To investigate the levels of ox-LDL in patients with cerebral infarction，and to evaluate the effect of the supplement therapy with probucol on the plasma concentrations of ox-LDL. Methods    ox-LDL, NO and eNOS concentrations were measured in subjects of cerebral infarction normotensive group, cerebral infarction with hypertension group and health control group, each of which had 60 cases. Patients in acute cerebral infarction normotensive group and hypertension group were randomized to divided into intervention group and nonintervention group respectively. Patients in the intervention group had been treated with probucol for 12 weeks. Then ox-LDL, eNOS, NO were measured after 2 weeks and 12 weeks of supplementation. Results  The levels of ox-LDL in plasma were raised significantly in patients with acute cerebral infarction (P<0.05), as well as the levels of eNOS and NO in serum were reduced obviously (P<0.05). The ADMA and Hcy levels in cerebral infarction hypertension group were higher than those in cerebral infarction normotension group (P<0.05), while the eNOS and NO levels were lower (P<0.05). With supplementation of probucol for 2 weeks and 12 weeks, the level of ox-LDL were decreased significantly (P<0.05). Conclusion  The present study demonstrated that ox-LDL which inhibited eNOS, reduced NO production, eading to endothelial dysfunction, was regarded as a risk fator of cerebral infarction. With supplementation of probucol, levels of ox-LDL were able to be decreased significantly, and sequential improvement of the endothelial function, which was propitious to anti-artherosclerosis. These findings provided a novel target for pharmacotherapy of cerebral infarction.

Key words: Probucol, brain infarction, hypertension, lipoproteins, LDL, nitric oxide synthase, nitric oxide, 氧化型低密度脂蛋白