普罗布考联合辛伐他汀对急性冠脉综合征患者颈动脉内膜中层厚度及血管内皮功能影响.docVIP

普罗布考联合辛伐他汀对急性冠脉综合征患者颈动脉内膜中层厚度及血管内皮功能影响【摘要】 目的 探讨联合应用普罗布考和辛伐他汀对急性冠状动脉综合征(ACS)患者颈动脉内膜中层厚度和血管内皮功能的影响。方法 急性冠状动脉综合征患者60例,随机分为单服辛伐他汀组(A组,辛伐他汀40 mg/d,n=30)以及辛伐他汀及普罗布考联合治疗组(B组,辛伐他汀40 mg/d,普罗布考0.5 g,2次/d,n=30),检测外周血总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及氧化低密度脂蛋白(ox-LDL)水平,用药治疗3个月,观察治疗前后的指标变化。应用高频超声检测颈动脉内膜中层厚度(CIMT)及肱动脉内皮依赖血管舒张功能(FMD),用药治疗3个月,观察治疗前后的指标变化。结果 两组治疗前各项指标差异无统计学意义。治疗3月后两组患者外周血TC、LDL-C、ox-LDL、CIMT均较治疗前降低,FMD改善。但联合治疗组降低的幅度较单独治疗组大。结论 对于ACS患者辛伐他汀合用抗氧化治疗能进一步降低血脂、降低CIMT及改善血管内皮功能。 【关键词】急性冠脉综合征;辛伐他汀;普罗布考;颈动脉内膜中层厚度;血管内皮功能 Effects ofprobucol combined with simvastatin on carotid intimamedia thickness andvascular endothelial function in patients with acute coronary syndrome LIU Yong,ZHANG Huan,LI Huan-ming,et al.Department of Cardiovascular,Fourth Central Hospital of Tianjin,Tianjin 300140,China 【Abstract】 Objective To investigate the influences of probucol combined with simvastation on carotid intimamedia thickness(CIMT)and vascular endothelial function in patients with acute coronary(ACS).Methods A total of 60 ACS patients randomly received standard therapy plus simvastatin(A,simvastatin 40 mg/d,n=30)or standard therapy plus simvastatin combined with probucol(B,simvastatin 40 mg/d and probucol 0.5 g,2/d,n=30).The serum total cholesterol,low density lipoprotein cholesterol and ox-LDL level were measured.These variables were analyzed before and after the therapy 3 months.The changes of CIMT and the brachial arterial hyperemia-induced flow mediated dilation(FMD)and sublingual nitroglycerin(NTG)mediated vasodilatations were measured by high resolution ultrasound.Results The indexes were no difference between the two groups before the therapy but significant difference 3 month after the therapy.Conclusion Simvastatin combined with ntioxidant probucol therapy have a synergism in the decreases of blood fat,and CIMT,and improvement of vessel endothelium. 【Key words】Acute coronary syndrome;Simvastatin;Probucol;Carotid intimamedia thickness;Vascular endothelial function 作者单位:3001