普罗布考联合阿托伐他汀对经皮冠状动脉介入治疗后再狭窄的影响

摘要

目的 研究普罗布考和阿托伐他汀联合用药对经皮冠状动脉介入治疗(PCI)后再狭窄的预防作用及其对炎症因子高敏C反应蛋白(hsCRP)水平的影响.方法 将100例准备行PCI治疗的稳定型心绞痛患者随机分为两组:联合组50例,予以普罗布考(1 000 mg/d)和阿托伐他汀(40 mg/d)联合治疗;单药组50例,予以阿托伐他汀40 mg/d)治疗.两组患者手术前4周开始服用,4周后行金属裸支架植入术.术后继续服用至24周.测定术前(0小时)、术后24小时、72小时、2周、4周、8周时hsCRP水平;24周复查冠状动脉造影.结果 两组PCI后24小时、72小时、2周、4周、8周时hsCRP水平均较治疗前明显增高,分别为联合组(8.2±1.4) mg/L、(17.9±2.6) mg/L、(19.3±3.1) mg/L、(13.5±1.9) mg/L、(9.1±1.6) mg/L、(7.9±1.4) mg/L vs单药组(8.1±1.2) mg/L、(19.2±2.7) mg/L、(22.4±3.8) mg/L、(18.3±2.8) mg/L、(15.7±2.1) mg/L、(8.3±2.0) mg/L,与术前0小时比较差异均具有统计学意义(P＜0.05),两组术后2～4周hsCRP水平逐渐下降并趋于稳定;联合组术后2周、4周的hsCRP水平显著低于单药组(P＜0.05);两组术后8周时差异无统计学意义(P＞0.05);复查冠状动脉造影结果显示24周时联合组再狭窄率(19.4％)低于单药组(32.3％)(P＜0.01).结论 PCI患者联合服用普罗布考、阿托伐他汀比单纯服用阿托伐他汀效果更优.%Objective To evaluate the effect of probucol combined with atorvastatin in the prevention of restenosis and serum level of hs-C-reactive protein (hsCRP) of patients after percutaneous coronary intervention. Methods A total of 100 patients with stable angina pectoris were randomly divided into two groups: combined medication group ( n = 50) and single medication group ( n =50). Patients were given atorvastatin 40 mg/d or probucol 1 000 mg/d combined with atorvastatin 40 mg/d in two groups for 4 weeks before PCI. After 4 weeks of premedication.the two groups underwent bare metal stent in plantation. Probucol and atorvastatin were continued until follow-up angiography performed at 24 weeks after PCI. The level of serum hsCRP was measured before PCK0 h) ,and 24 h,72 h,2 weeks, 4 weeks and 8 weeks after PCI. Coronary angiography was performed in follow-up at 24 weeks after PCI. Results Compared with the level at 0 h,hsCRP in both groups increased significantly at 24 h and 72 h,2 weeks,4 weeks and 8 weeks after PCI,(8. 2+1. 4) mg/L, (17. 9 + 2. 6) mg/L, (19. 3 + 3.1) mg/L, (13. 5+1. 9) mg/L, (9.1 ?.6) mg/L,(7. 9 + 1.4) mg/L and (8.1 + 1.2) mg/L, (19. 2?. 7) mg/L, (22. 4 + 3. 8) mg/L, (18. 3 + 2. 8) mg/L, (15. 7?. 1) mg/L, (8. 3 + 2. 0) mg/L( P 0. 05). Re-check coronary angiography was performed 24 weeks after PCI,and it showed that the restenosis rate was 19. 4% in the combined medication group and 32.3% in the single medication group( P <0. 01). Conclusion Administration of probucol combined with atorvastatin can reduce the rate of coronary restenosis when compared with single atorvastatin.