Takahashi T, Hiasa Y, Harada S, Hosokawa S, Kato S, Tanimoto M, Kishi K, Ohtani R
Cardiovascular Department, Komatsushima Red Cross Hospital, Tokushima.
J Cardiol. 1997 Aug;30(2):67-72.
The influence of probucol-induced low high-density lipoprotein (HDL) cholesterolemia on the progression of coronary atherosclerosis was studied in 320 patients with angina pectoris or myocardial infarction, 32 patients with probucol 500 mg/day, 288 patients without probucol, who underwent follow-up angiography at intervals of at least 2 years. The 288 patients were divided into two groups depending on the serum HDL-cholesterol (HDL-C) level at the follow-up angiography: the low HDL-C group had a serum HDL-C level below 40 mg/dl (152 patients) and the control group had 40 mg/dl or above (136 patients). Coronary sclerosis index was defined as the total products of coronary scores (0-6) by segments according to the American Heart Association reporting system in the branches without angioplasty and was compared between the three groups. In the probucol group, serum HDL-C level was significantly reduced from 43.9 +/- 10.6 (at baseline) to 31.1 +/- 7.6 mg/dl (at follow-up, p < 0.01) and was lower than that in the other two groups (low HDL-C group 33.1 +/- 5.0 mg/dl, p < 0.07; control group 52.6 +/- 9.8 mg/dl, p < 0.01). Coronary sclerosis index was most increased in the low HDL-C group (8.3 +/- 5.4-->11.9 +/- 6.1, p < 0.01), whereas there was no significant change in the probucol group (7.2 +/- 5.9-->9.1 +/- 6.8, p = 0.24). Our results showed that treatment with probucol inhibits the progression of coronary atherosclerosis despite the decrease in HDL-C level. One possible reason may be remarkable improvement in the other lipid factors, especially the low-density lipoprotein cholesterol level (165.7 +/- 33.9-->123.7 +/- 29.0 mg/dl, p < 0.01).
在320例心绞痛或心肌梗死患者中研究了丙丁酚诱导的低高密度脂蛋白（HDL）胆固醇血症对冠状动脉粥样硬化进展的影响。32例患者服用丙丁酚500mg/天，288例患者未服用丙丁酚，这些患者至少每2年进行一次随访血管造影。根据随访血管造影时的血清HDL胆固醇（HDL-C）水平，将288例患者分为两组：低HDL-C组血清HDL-C水平低于40mg/dl（152例患者），对照组血清HDL-C水平为40mg/dl或更高（136例患者）。冠状动脉硬化指数根据美国心脏协会报告系统，在未进行血管成形术的分支中按节段计算冠状动脉评分（0 - 6）的总和，并在三组之间进行比较。在丙丁酚组中，血清HDL-C水平从基线时的43.9±10.6显著降至随访时的31.1±7.6mg/dl（p < 0.01），且低于其他两组（低HDL-C组33.1±5.0mg/dl，p < 0.07；对照组52.6±9.8mg/dl，p < 0.01）。冠状动脉硬化指数在低HDL-C组增加最多（8.3±5.4→11.9±6.1，p < 0.01），而丙丁酚组无显著变化（7.2±5.9→9.1±6.8，p = 0.24）。我们的结果表明，尽管HDL-C水平降低，但丙丁酚治疗仍可抑制冠状动脉粥样硬化的进展。一个可能的原因可能是其他脂质因子有显著改善，尤其是低密度脂蛋白胆固醇水平（165.7±33.9→123.7±29.0mg/dl，p < 0.01）。
