普罗布考对冠心病患者ox-LDL的作用研究

发布时间：2018-06-07 13:42

本文选题：普罗布考 + 氧化型低密度脂蛋白　；参考：《河北北方学院》2015年硕士论文

【摘要】：随着对动脉粥样硬化(AS)发病机制的研究不断进展,Steinberg教授于1983年提出了氧化学说,认为LDL被氧化修饰形成氧化型低密度脂蛋白(ox-LDL)是AS病变发生的中心环节。2005年《循环》杂志发表一项前瞻性随机对照研究,探讨在既往无心血管及糖尿病病史的人群中,血清ox-LDL与心血管事件发生风险的关系,平均随访5.6年。在调整传统风险因素后发现,ox-LDL高组是ox-LDL低组风险的4.25倍,说明ox-LDL是心血管事件的预测因子。2011年Ruile Fang等[1]学者研究了我国汉族人群血浆ox-LDL与颈动脉粥样硬化的关系,发现易损斑块组ox-LDL明显高于稳定斑块组(P=0.015),表明中国汉族人群中ox-LDL是颈动脉粥样斑块不稳定的生物指标。冠状动脉粥样硬化性心脏病作为全身动脉粥样硬化疾病的一部分,具有高发病率及死亡率的特点,但目前临床对冠心病的抗氧化治疗应用较局限。普罗布考的化学名为4,4’-[(1-甲基亚乙基)双(硫)]-双[2,6-双(1,1-二甲基乙基)]苯酚,两个酚羟基极容易被氧化,可以捕获血浆和内皮下活性氧;被氧化后形成双自由基中间体,分子重排,发生C-S键断裂,形成联苯醌(普罗布考的代谢产物),联苯醌结构稳定,因此阻止了氧离子对LDL表面的多不饱和脂肪酸的氧化,从而抑制了LDL的氧化修饰为ox-LDL。本研究将60例冠心病患者随机分为2组,每组30例,分别为:对照组(AS组)(阿司匹林100mg/d,阿托伐他汀20 mg/d)和试验组(PAS组)(普罗布考500mg/d,阿司匹林100mg/d,阿托伐他汀20 mg/d),疗程为3个月,所有入选病例分别于PCI治疗前及治疗后3个月应用酶联免疫吸附法(ELISA)测定ox-LDL水平。研究结果显示,试验组与对照组血清ox-LDL水平均较治疗前降低,且PAS组较对照组降低更明显(P0.05)。综上所述,普罗布考与他汀类药物联用降低血清ox-LDL的疗效优于单用他汀类药物,两种药物间可能具有协同作用。
[Abstract]:With the progress in the study of the pathogenesis of ASA, Professor Steinberg put forward the oxidation theory in 1983. It is believed that oxidative modification of LDL to oxidized low density lipoprotein (ox-LDL) is central to the pathogenesis of atherosclerosis. A prospective randomized controlled study was published in 2005 in the Journal of Circulation to explore people with no history of cardiovascular and diabetes mellitus. The relationship between serum ox-LDL and risk of cardiovascular events was followed up for an average of 5.6 years. After adjusting for the traditional risk factors, it was found that the high level of ox-LDL was 4.25 times higher than that of the lower group of ox-LDL, indicating that ox-LDL is a predictor of cardiovascular events. [1] Ruile Fang et al studied the relationship between plasma ox-LDL and carotid atherosclerosis in Chinese Han population in 2011. It was found that ox-LDL in vulnerable plaque group was significantly higher than that in stable plaque group, indicating that ox-LDL was a biomarker of carotid atherosclerotic plaque instability in Chinese Han population. Coronary atherosclerotic heart disease, as a part of systemic atherosclerosis disease, has the characteristics of high morbidity and mortality, but the application of antioxidation therapy to coronary heart disease is limited. The chemical name of Probucol is 4o 4n- [1 methylene ethylidene bis (sulfur)]-bis [2o 6 bis (dimethyl ethyl)] phenol, two phenolic hydroxyl groups are oxidized very easily and can capture reactive oxygen species in plasma and endodermis; after being oxidized, they form a bisradical intermediate, The C-S bond breaks in molecular rearrangement to form dibenzoquinone (the metabolite of Probucol, dibenzoquinone), which prevents the oxidation of polyunsaturated fatty acids on the surface of LDL by oxygen ions, and thus inhibits the oxidation of LDL to ox-LDL. In this study, 60 patients with coronary heart disease were randomly divided into two groups: control group (Aspirin 100 mg / d, Atto vastatin 20 mg / d) and test group (Probucol 500 mg / d, aspirin 100 mg / d, Atto vastatin 20 mg / d) and control group (Aspirin 100 mg / d, Atto vastatin 20 mg / d). Ox-LDL levels were measured by Elisa before and 3 months after PCI treatment. The results showed that the level of serum ox-LDL in the experimental group and the control group was lower than that in the control group, and that in the PAS group was significantly lower than that in the control group (P 0.05). In conclusion, the efficacy of probucol combined with statins in reducing serum ox-LDL is better than that of statins alone, and there may be a synergistic effect between the two drugs.
【学位授予单位】：河北北方学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4

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