普罗布考联合阿托伐他汀和阿司匹林治疗颈动脉粥样硬化的疗效

Therapeutic efficiency of probucol combined with atorvastatin and aspirin in treatment of carotid atherosclerosis

摘要:

目的 观察普罗布考、阿托伐他汀、阿司匹林联合应用（PAS疗法）对颈动脉粥样硬化症的疗效。方法 入选73例经B超证实有颈动脉粥样硬化斑块的患者，随机分为PAS组和AS组，随访6个月。其中PAS组37例，给予普罗布考0.375g×2次/d、阿托伐他汀10mg/d、阿司匹林100mg/d；AS组36例，给予阿托伐他汀10mg/d、阿司匹林100mg/d。观察治疗前后患者的血脂水平、血清氧化型低密度脂蛋白（ox-LDL）及血清C反应蛋白（CRP）水平，超声检测治疗前后颈动脉内-中膜厚度（IMT）及斑块厚度。结果 治疗前PAS组及AS组血脂、ox-LDL CRP、IMT及斑块厚度基线水平差异无统计学意义（P＞0.05）。治疗后PAS组及AS组以上指标均降低，差异有统计学意义（P＜0.05）；除TG和HDL-C外，PAS组较AS组降低更明显，差异有统计学意义（P＜0.05）。结论 普罗布考联合阿托伐他汀和阿司匹林治疗在降低血脂的同时，可降低患者的ox-LDL及CRP水平，疗效较单纯阿托伐他汀和阿司匹林治疗明显，同时也可改善患者的IMT及斑块总积分；稳定颈动脉粥样硬化斑块需长期干预治疗及随访观察。

Abstract:

Objective To investigate the effects of combined therapy of probucol, atorvastatin, and aspirin (PAS) on carotid atherosclerosis. Methods A total of 73 ultrasonograhy-identified carotid atherosclerosis patients who admitted in our hospital from January 2011 to January 2012 were enrolled in this study. They were prospectively and randomly divided into 2 matched groups: PAS treatment group (n=37) and atorvastatin plus aspirin (AS) control group (n=36). The patients from PAS treatment group received a treatment of probucol 0.375g/times, twice daily, atorvastatin 10mg/d, and aspirin 100mg/d for 6 months, and those of AS control group were treated with atorvastatin 10mg/d, and aspirin 100mg/d for same duration. Before and after treatment, the serum levels of lipids, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), oxidized low-density lipoproteins (ox-LDL) and C-reactive protein (CRP) were detected. Carotid intima media thickness (IMT) and plaque thickness were examined by ultrasonography. Results There was no significant difference in the serum levels of lipids, ox-LDL and CRP, and IMT and plaque thickness in PAS treatment group and the AS control group before treatment (P＞0.05). But after treatment, all above indicators were significantly decreased than those before treatment (P＜0.05). Except TG and HDL-C, PAS treatment group had more significant decrease in these indicators compared with AS control group (P＜0.05). Conclusion PAS combination therapy decreases the serum lipids, and simultaneously reduces the serum levels of ox-LDL and CRP significantly, with better effects than the AS combination. This treatment evidently attenuates IMT and total scores of plague. But its effect on carotid atherosclerotic plaque needs long-term intervention and follow-up.