摘要
目的观察普罗布考与阿托伐他汀联合治疗对急性冠状动脉综合征患者血脂、血清氧化型低密度脂蛋白水平及对氧磷酶1活性的影响。方法38例急性冠状动脉综合征患者随机分为对照组(n=20,阿托伐他汀10mg/d)和治疗组(n=18,阿托伐他汀10 mg/d+普罗布考1 000 mg/d),随访4周。两组在治疗前后分别测定血清总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、血清氧化型低密度脂蛋白水平及对氧磷酶1活性。结果治疗4周后,对照组低密度脂蛋白胆固醇降低15.4%、高密度脂蛋白胆固醇上升13.7%(P<0.05),血清总胆固醇、甘油三酯略有下降但未达到统计学意义(P>0.05);治疗组血清总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯分别下降28.1%、28.5%、14.2%(P<0.01)和23.3%(P<0.05);与对照组相比,治疗组血清总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇下降更为明显(P<0.01)。治疗后,两组血清氧化型低密度脂蛋白水平均明显降低,对氧磷酶1活性均明显升高(P<0.01);而治疗组血清氧化型低密度脂蛋白水平和对氧磷酶1活性的变化比对照组更为明显(P<0.01)。治疗前的血清氧化型低密度脂蛋白水平、对氧磷酶活性及两者治疗后的变化值与血脂各指标之间均无相关关系(P>0.05),而对氧磷酶活性与血清氧化型低密度脂蛋白水平呈显著负相关(r=-0.669,P<0.01)。结论阿托伐他汀与普罗布考合用具有协同降胆固醇作用和抗氧化作用,但普罗布考降高密度脂蛋白胆固醇的作用不能被阿托伐他汀抵消。
Aim To observe the effect of atorvastatin combined with probucol on the levels of serum lipids,oxidized low density lipoprotein（ox-LDL） and the activity of paraoxonase-1（PON1） in patients with acute coronary syndrome（ACS）. Methods A randomized,open study was performed on a total of 38 patients（including 27 males and 11 females,the average age was 63.7±8.9 years） with ACS.The patients were randomly assigned to a control group（atorvastatin 10 mg/day,n=20） or a treatment group（atorvastatin 10 mg/day and probucol 1 000 mg/day,n=18）.All of them were followed up for 4 weeks.Serum levels of total cholesterol（TC）,low density lipoprotein cholesterol（LDLC）,high density lipoprotein cholesterol（HDLC）,triglyceride（TG）,ox-LDL and PON1 activity were measured before and after treatment. Results After 4 weeks of treatment,LDLC levels reduced by 15.4% and HDLC increased by 13.7% in the control group compared with baseline（P〈0.05）,but the decreases in TC and TG were not significant（P〉0.05）;the serum levels of TC,LDLC,HDLC and TG in the treatment group decreased significantly（-28.1%,-28.5%,-14.2% and-23.3%,respectively,P〈0.01 or 0.05）;The decline of TC,and HDLC in treatment group was more significant than that in the control group（P〈0.01）.After treatment,serum ox-LDL levels declined significantly and PON1 activity increased significantly in both groups compared with baseline（P〈0.01）;The changes of ox-LDL levels and PON1 activity were more significant in the treatment group than those in the control group（P〈0.01）.No relationships were observed between TC,TG,LDLC,HDLC and ox-LDL or PON1 before and after treatment（P〉0.05）,but the serum levels of ox-LDL and PON1 had a significant negative correlation by Pearson correlation analysis（r=-0.669,P〈0.01）. Conclusion The addition of probucol to atorvastatin has a synergistic effect in lowing the cholesterol and antioxidant,but atorvastatin can not offset the HDLC decreasing effect of probucol.
出处
《中国动脉硬化杂志》
CAS
CSCD
北大核心
2009年第11期933-937,共5页
Chinese Journal of Arteriosclerosis
