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目的:评价普罗布考与阿托伐他汀联合对急性冠状动脉(冠脉)综合征患者的血脂、氧化低密度脂蛋白(OX-LDL)及炎症因子的影响。方法:122例急性冠脉综合征的患者随机分为单药治疗组(n=60,阿托伐他汀10 mg/d)和联合治疗组(n=62,阿托伐他汀10 mg/d+普罗布考500 mg/d)。分别于24小时内及治疗后4周、8周检测高敏C-反应蛋白(Hs-CRP)、氧化低密度脂蛋白、纤维蛋白原(FIB)、白介素6(IL-6)以及血脂六项,记录两组患者的不良反应发生情况。结果:治疗8周后联合治疗组的低密度脂蛋白胆固醇、载脂蛋白-B、氧化低密度脂蛋白、白介素6、高敏C-反应蛋白较单药治疗组下降更明显,差异有统计学意义(P<0.01)。通过多元相关分析,提示氧化低密度脂蛋白与高敏C-反应蛋白之间具有相关性(r=0.35,P<0.01)。结论:阿托伐他汀与普罗布考联合应用能更显著降低氧化低密度脂蛋白以及低密度脂蛋白胆固醇、载脂蛋白-B、高敏C-反应蛋白、白介素6的水平,可能通过降脂、抗炎、抗氧化的作用机制对稳定斑块有一定的作用。
Objective: To evaluate the effects of probucol combined with atorvastatin on serum lipids, oxidized low density lipoprotein (OX-LDL) and inflammatory cytokines in patients with acute coronary syndrome (ACS). Methods: One hundred and twenty-two patients with acute coronary syndrome were randomly divided into monotherapy group (n = 60, atorvastatin 10 mg / d) and combination therapy group (n = 62, atorvastatin 10 mg / Cloth test 500 mg / d). High-sensitivity C-reactive protein (Hs-CRP), oxidized low density lipoprotein, fibrinogen (FIB), interleukin 6 (IL-6) and blood lipids were detected within 24 hours and 4 weeks and 8 weeks after treatment. Record the adverse reactions of two groups of patients. Results: After 8 weeks of treatment, the LDL-C, APO-B, LDL, IL-6 and Hypersensitive C-reactive protein decreased more significantly in the combined treatment group than in the monotherapy group, with significant difference (P <0.01). Multivariate correlation analysis suggested that there was a correlation between oxidized low-density lipoprotein and high-sensitivity C-reactive protein (r = 0.35, P <0.01). Conclusion: The combination of atorvastatin and probucol can significantly reduce the levels of oxidized low-density lipoprotein, low-density lipoprotein cholesterol, apolipoprotein-B, high-sensitivity C-reactive protein and interleukin-6, Anti-inflammatory, anti-oxidant mechanism of action has a certain effect on the stability of plaque.