阿托伐他汀与普罗布考联合应用对边缘型冠状动脉病变患者血浆胱抑素 C 水平及冠状动脉病变严重程度的影响。

Combined effect of atorvastatin and probucol on plasma cystatin C levels and severity of coronary lesion in patients with borderline coronary lesion.

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

出版信息

Chin Med J (Engl). 2012 Jul;125(14):2472-6.

Abstract

BACKGROUND

The plasma cystatin C concentration (PcyC) has been demonstrated to have prognostic value in acute coronary syndrome, but the study of PcyC in patients with borderline coronary lesions is limited. Moreover, the effects of atorvastatin and probucol on PcyC and the severity of coronary lesions are unknown. This study was to evaluate the effects of the combination of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline coronary lesions.

METHODS

One hundred and thirty consecutive patients with borderline coronary lesions (40% to 60% isolated single stenosis assessed by quantitative coronary angiography) were enrolled into the borderline coronary lesion (BCL) group, and one hundred and thirty-six subjects without coronary lesions comprised the controls (CTR). The subjects in the BCL group were randomized into routine treatment (RTT, n = 60), and combined treatment with atorvastatin 20 mg plus probucol 1.0 g daily added to routine medication (CBT, n = 70), both groups were treated for 6 months continuously. The levels of PcyC, high-sensitive C-reactive protein (hs-CRP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were determined. One hundred and four subjects in the BCL group were rechecked by coronary angiography.

RESULTS

PcyC levels were significantly higher in the BCL group than in the CTR group; (2003.26 ± 825.73) ng/ml vs. (1897.83 ± 664.46) ng/ml (P < 0.01). Compared with patients in the RTT group, the levels of PcyC, TC, LDL-C, TG and hs-CRP were significantly lower in the CBT group (P < 0.05). Moreover, there was a trend towards a slight decrease in the RTT patients, (54.38 ± 10.67)% vs. (50.29 ± 9.89)% (P > 0.05), and a significant decrease in the CBT patients, (53.65 ± 9.48%) vs. (40.38 ± 12.93)% (P < 0.05), in the mean percent stenosis of borderline coronary lesions before and after six months of treatment.

CONCLUSIONS

Cystatin C played an important role in the development of coronary artery disease, and was associated with the severity of coronary lesions. The combination of atorvastatin and probucol decreased PcyC levels, and could be the treatment of choice.

摘要

背景

血浆半胱氨酸蛋白酶抑制剂 C 浓度（PcyC）已被证明在急性冠状动脉综合征中有预后价值，但关于边缘性冠状动脉病变患者的 PcyC 研究有限。此外，阿托伐他汀和普罗布考对 PcyC 和冠状动脉病变严重程度的影响尚不清楚。本研究旨在评估阿托伐他汀和普罗布考联合治疗对边缘性冠状动脉病变患者 PcyC 和冠状动脉病变严重程度的影响。

方法

连续纳入 130 例边缘性冠状动脉病变患者（定量冠状动脉造影评估 40%-60%孤立性单狭窄）进入边缘性冠状动脉病变（BCL）组，136 例无冠状动脉病变者为对照组（CTR）。BCL 组患者随机分为常规治疗（RTT）组（n=60）和阿托伐他汀 20mg 加普罗布考 1.0g 每日联合常规药物治疗（CBT）组（n=70），两组均连续治疗 6 个月。测定 PcyC、高敏 C 反应蛋白（hs-CRP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）水平。BCL 组 104 例患者再次行冠状动脉造影检查。

结果

BCL 组患者的 PcyC 水平明显高于 CTR 组；（2003.26±825.73）ng/ml 比（1897.83±664.46）ng/ml（P<0.01）。与 RTT 组相比，CBT 组的 PcyC、TC、LDL-C、TG 和 hs-CRP 水平明显降低（P<0.05）。此外，RTT 组患者的 PcyC 水平呈轻度下降趋势，（54.38±10.67）%比（50.29±9.89）%（P>0.05），CBT 组患者的 PcyC 水平明显下降，（53.65±9.48）%比（40.38±12.93）%（P<0.05），治疗后 6 个月边缘性冠状动脉病变的平均狭窄程度。