血脂康对颈动脉粥样硬化患者血管内皮功能及氧化还原平衡的影响

目的 探讨血脂康对颈动脉粥样硬化患者调脂作用及对血管内皮功能和血浆氧化还原平衡的影响.方法 选择来我院心内科住院的颈动脉粥样硬化患者108例,随机分为血脂康组(54例)和考来烯胺组(54例),分别测定两组患者治疗12周前后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、一氧化氮(NO)、内皮素-1(ET-1)、还原型谷胱甘肽(GSH)和氧化型谷胱甘肽(GSSG),并根据Nernst方程计算GSH/GSSG氧化还原电位.结果 治疗12周后,TC、LDL-C和TG血脂康组从治疗前的(5.68±1.47、3.43±1.36、1.73±0.6 6)mmol/L降低到治疗后的(3.94±1.36、2.28±1.11、1.54±0.59)mmol/L(t值分别为3.915、4.160、2.187,P值分别为<0.01、0.01、0.05),考来烯胺组(5.73±1.52、3.37±1.35、1.72±0.67)mmol/L降低到治疗后的(4.15±1.29、2.56±1.06、1.69±0.57)mmol/L(t值分别为3.760、4.035、1.893,P值分别为<0.01、0.01、>0.05);血脂康组ET-1、GSSG、GSSG/GSH从[(154.43±63.06)ng/L、(33.93±1.74)μmol/L、-142.3±4.3]降低到[(121.71±59.11)ng/L、(30.42±1.59)μmol/L、-146.1±4.4(t值分别为2.168、2.325、4.168,P值分别为<0.05、0.05、0.01)];NO、NO/ET-1、GSH、GSH/GSSG从(48.41±16.53)μmol/L、0.33±0.16、(286.11±38.23)μmol/L、8.65±1.18升高到(64.40±18.86)μmol/L、0.54±0.19、(321.27±56.47)μmol/L、10.56±1.70(t值分别为3.725、3.987、3.894、4.168,P值分别为<0.01、0.01、0.01、0.01).结论 对颈动脉粥样硬化患者,血脂康和考来烯胺均可有效调脂,但仅血脂康对血管内皮功能有一定的保护作用,且可使氧化还原平衡向还原方向偏移.

Effect of xuezhikang on vascular endothelial function and redox balance in patients with carotid atherosclerosis

Objective To explore the effect of xuezhikang on blood lipids,vascular endothelial function and redox balance in patients with carotid atherosclerosis.Methods A total of 108 inpatients with carotid atherosclerosis in cardiology department were randomly divided into two groups:xuezhikang group (n = 54) and cholestyramin group (n= 54).Before and after treatment,the levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),nitric oxide (NO),endothelin-1 (ET-1),reduced glutathione (GSH) and oxidized glutathione (GSSG) of all patients were measured.The GSH/GSSG as redox potentials were calculated according to Nernst equation.Results After 12 weeks of treatment,the levels of blood lipids were lower than before treatment in xuezhikang group [TC:(3.94±1.36) mmol/L vs.(5.68±1.47) mmol/L;LDL-C:(2.28±1.11) mmol/L vs.(3.43±1.36) mmol/L;TG:(1.54±0.59) mmol/L vs.(1.73±0.66)mmol/L;t=3.915,4.160,2.187;P<0.01,0.01,0.05,respectively],and the levels of blood lipids also decreased in cholestyramin group [TC:(4.15 ± 1.29) mmol/L vs.(5.73 ± 1.52)mmol/L;LDLC:(2.56± 1.06) mmol/L vs.(3.37± 1.35) mmol/L;TG:(1.69±0.57) mmol/L vs.(1.72±0.67) mmol/L;t=3.760,4.035,1.893;P<0.01,0.01,>0.05,respectively].In xuezhikang group,ET-1,GSSG and GSSG/GSH ratios decreased significantly [(121.71 + 59.11) ng/L vs.(154.43±63.06) ng/L;(30.42± 1.59) μmol/L vs.(33.93±1.74) μ mol/L;-146.1±4.4vs.-142.3±4.3;t=2.168,2.325,4.168;P<0.05,0.05,0.01,respectively],and NO,NO/ET-1 ratios,GSH and GSH/GSSG increased significantly [(64.40 ± 18.86) μmol/L vs.(48.41 ±16.53) μmol/L;(0.54±0.19) vs.(0.33±0.16);(321.27±56.47) μmol/L vs.(286.11±38.23)μmol/L;(10.56±1.70) vs.(8.65±1.18);t=3.725,3.987,3.894,4.168;all P<0.01].Conclusions For patients with carotid atherosclerosis,both xuezhikang and cholestyramin could lower blood lipids efficiently,but only xuezhikang could protect vascular endothelial function partly,and makes plasma redox imbalance shift the balance.