普罗布考对高脂血症患者血脂及血管内皮舒张功能的影响

目的　评价普罗布考降血脂的同时对高脂血症患者血管内皮舒张功能的影响。方法　采用自身对照和组间对照 ,将 5 2例原发性高脂血症患者分为两组 ,其中普罗布考组 (36例 ) ,服用普罗布考 0 .5 ,Bid;普伐他汀组 (16例 ) ,服用普伐他汀 10 mg,QN,疗程均为 4周。选择血脂正常的 2 0例健康者为空白对照组。采用高分辨率超声技术 ,对治疗前后血管内皮舒张功能进行检测。结果　 1高脂血症患者治疗前肱动脉血流介导的舒张功能 (FMD)明显低于正常对照组 (4.6± 3.2 ) %比 (12 .8± 3.5 ) % ,P<0 .0 1],而对硝酸甘油的反应 (NMD)正常。 2普罗布考明显降低总胆固醇 (TC)、低密度脂蛋白胆固醇 (L DL - c)和高密度脂蛋白胆固醇 (HDL - c) ,三酰甘油变化不明显。 3普罗布考使 FMD明显增强 ,NMD无显著性改变。 4普罗布考降 TC及对 FMD的改善作用均不比普伐他汀差 (分别P<0 .0 1和 P<0 .0 5 )。 5 FMD的改善与 TC及 L DL - c无相关性。结论　普罗布考短期治疗即可显著降低血脂 ,并明显改善 FMD,可作为良好的保护内皮功能的药物 ,其改善 FMD的作用与降脂无关

Effects of probucol on lipid and brachial endothelial relaxing function in patients with hyperlipidemia

Objective To evaluate the effects of probucol on lipid and brachial endothelial relaxing function in patients with hyperlipidemia. Methods Using random and single blind contrast, 52 patients with hyperlipidemia were devided into probucol group (n=36) and pravastatin group (n=16), 20 healthy people (without hyperlipidemia) were enrolled as control group. With high-resolution ultrasound technique, the flow mediated vasodilation (FMD) and non- flow mediated dilatation (after sublingual administration of glyceryl trinitrate, NMD) were measured before and after therapy. Results ①FMD was significantly impaired in the hyperlipidemia group compared with the normal control group (4.6±3.2)% vs (12.8±3.5 ) %, P<0.01], but NMD was normal. ②The levels of total cholesterol (TC), low-density cholesterol (LDL-c) and high density cholesterol (HDL-c) were reduced markedly ,and FMD was improved significantly after therapy. ③The efficacy of probucol on TC and FMD were not inferior to pravastatin (P<0.01, 0.05, respetively). ④The improved of FMD was not depended on the levels of TC and LDL-c. Conclusion Probucol can reduced the levels of TC, HDL-c and LDL-c and improved FMD in short period, and can be used in clinical practice. There is no relationship between the improvement on FMD and the levels of TC and LDL-c.