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普罗布考在心血管疾病中的应用进展
邵帅;刘彤;富华颖;李广平
【期刊名称】《中国心血管杂志》
【年(卷),期】2013(018)001
【摘要】普罗布考（probucol），化学名为丙丁酚，化学式为4，4＇-[（1．甲基亚乙基）二双]2，6-二（1，1-二甲基乙基）苯酚，于20世纪70年代首先于美国上市并应用于临床，以往认为其主要作用是降低血清胆固醇。
近年来研究发现，普罗布考除具有降脂作用外，还具有抗动脉粥样硬化（atherosclerosis，AS）、抗氧化应激、保护血管内皮、预防对比剂急性肾损害（contrastinducedacutekidneyinjury，CIAKI）及抗心律失常等作用，且能够预防经皮冠状动脉介入治疗（PCI）术后再狭窄。
本文结合我们近年来的相关研究工作就普罗布考在心血管疾病中的应用进展做一综述。
【总页数】3页(P73-75)
【作者】邵帅;刘彤;富华颖;李广平
【作者单位】300211 天津医科大学第二医院心脏科天津心脏病学研究所
【正文语种】中文
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中国实用医刊2019年1丿］第46卷第2期Chinese Jour nal of Practical'ledicine2019.\.l.46,\().2・107・立普妥联合普罗布考预防冠心病PCI术后造影剂肾病的效果及对患者肾功能、炎症因子和氧化应激水平的影响张克连福建省泉州市第一医院心内科362000通信作者：张克连,Email：49668357@【摘要】目的探讨立普妥联合普罗布考预防冠心病经皮冠状动脉介入治疗(PCI)术后造影剂肾病(C1N)的效果及对患者肾功能、炎症因子和氧化应激水平的影响方法选取2016年6月至2017年6月泉州市第一医院150例行PCI术的冠心病患者为受试对象，采用随机数表法分为联合组与对照组，每组75例：对照组患者术前口服立普妥，联合组患者则在其基础上联合服用普罗布考进行预防比餐术前及术后48h两组患者肾功能指标［血清肌§f(Scr)、胱抑素-C(cys-C)、中性粒细胞明胶酶相关脂质运载蛋白(N(；AI.)］、炎症因子［血清超敏-C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-18(IL-18)］、氧化应激指标［血清8■异前列腺素-F2a(8-iso-PGF2a)、8-轻基脱氧鸟^(8-()H(IG)、丙二醛(MDA)］水平变化，分析术后3(1内两组患者药物不良反应发生情况及CI、发病率差异结果联合组患者术后4X h时血清Scr.Cys-C.NGAL水平与术前比较差异未见统计学意义(P均＞0.05),但均低于同期对照组(P均＜0.05)；两组患者血清hs-CRP JL-6JL-18、8・iso・PGF2ot、8・OH(1G、MDA水平均较术前提高，且联合组低于同期对照组(/〉均＜0.05)术后3(I内，两组患者各项药物不良反应发生率比较差异未见统计学意5C(P＞0.05),而联合组患者(：【、发病率低于对照组(/〉＜().()5)结论立普妥联合普罗布考可明显控制冠心病患者PCI术后炎症因子及氧化应激水平并维持其肾功能，进而有效预防CIN,对患者术后恢复有利【关键词】立普妥;普罗布考；经皮冠状动脉介入治疗；造影剂肾病I)()l：10.3760/cma.j.issn.1674-4756.2019.02.033Effects of lipitor combined with prohucol on preventing contrast-induced nephropathy after PCI inpatients with coronary heart disease and its influence on renal function,inflammatrov factors andoxidative stressZhang KelianDepartment of Cardiology,Quanzhou First Hospital,Quanzhou362000ChinaCorresponding author：Zhang Kelian,Email:49668357@［Abstract］Objective To investigate the effects of lipitor combined with probucol on preventionof contrast-induced nephropathy(CIN)id t er percutaneous coronary intenention(PCI)in patients withcoronary heart disease and its influence on renal function,inflammatory factors and oxitkitive stress.Methods A total of150patients with coronary heart disease undergoing PCI in Quanzhou First Hospitalfrom June2016to June2017were selected for study and were divided into the combined group and thecontrol group according to the random mnnber table method,with75cases in each group.The controlgroup was given oral lipitor before op e ration,and the combined group was given the probucol on thisbasis.The levels of the renal function indexes including serum creatinine(Scr),cystatin-C(Cys-C),neutrophil gelatinase-associated lipocalin(NG A L),inflammatory factors,such as sennnhigh-sensitivitv-C reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-18(IL-18),andoxidative stress indexes including8-isoprostaglandin-F2a(8-iso-PGF2a),8-hydroxy-2'-deoxyguanosine(8-()H(lG),nuilondialdehyde(MDA)before operation and48h after operation were compared betweenthe two groups.The occurrence of adverse drug reactions and the CIN morbidity in the two groups within3(I after operation were analyzed.Results I'here was no significanl difference in the levels of serum Scr,-108・中国实用庆刊2019年1丿］第4&卷第2期Chinese Journal of Practical Medicineman.2019.\d.46.W.2Cys-C or NGAL in the combined group48h after operation compared with those before operation(P all>0.05),but the levels were significantly lower than those in the control group at the same time(P all<0.05).The levels of serum hs-CRP,IL-6,IL-18,8-iso-PGF2a,8-OHdG and MDA in the two groupswere significantly higher than those before operation,and the levels in the combined group weresignificantly lower than those in the control group(P all<0.05).There was no significant difference inthe incidence of adverse drug reactions between the two groups within3d after operation(P all>0.05),and the C1N morbidity in the combined group was significantly lower than that in the control group(P<0.05).Conclusions Lipitor combined with probucol can significantly control the levels of inflammatoryfactors and oxidative stress and maintain their renal function in patients with coronaiy heart disease,andthen effectively prevent CIN,and it is favorable for the postoperative recoveiy of patients.[Keywords]IJpitor；Probucol；Percutaneous nephropathyDOI：10.3760/cma.j.issn.1674-4756.2019.02.033经皮冠状动脉介入治疗(PCI)作为临床公认的冠心病诊疗最有效治疗手段，近年来应用广泛，造影剂肾病(CIN)是PC1术后除冠状动脉再狭窄、支架内血栓之外的严重并发症，是医源性急性肾功能衰竭的主要致病途径,不仅降低患者治疗体验还增加医疗费用.令远期并发败血症、呼吸衰竭等严重病症的风险剧增，对预后极为不利。
普罗布考对冠状动脉粥样硬化性心脏病患者冠状动脉介入治疗后对比剂肾病的影响天津市胸科医院心内科董军、刘寅、孙跟义摘要目的:观察普罗布考对冠状动脉粥样硬化性心脏病(冠心病)患者行冠状动脉介入治疗后肾功能的影响。
方法:连续入选121例冠心病合并高血压并接受冠状动脉介入治疗的患者。
按照完全随机化原则分为使用普罗布考组和对照组(未用普罗布考）。
普罗布考组在冠状动脉造影前2天应用普罗布考375ｍｇ,2次／天,术后继续使用3天。
记录患者的基本资料及术后72h血清肌酐并用MDRD方法计算其术前、术后估计肾小球滤过率(eGFR)。
分析介入治疗后ＣIN的发生率,两组冠状动脉介入术前后eGＦR、血清肌酐的变化。
结果:普罗布考组手术前后ｅＧＦR、血清肌酐未有显著性差异。
而对照组术后ｅGFR 较术前明显降低(Ｐ<0.05),术后血清肌酐较术前明显增加(P＜0.０5)。
术后72 ｈ血清肌酐与基线血清肌酐的差值(ΔScr)对照组明显升高(Ｐ＜０.05），ΔeＧFR明显降低（P<0.05)。
普罗布考组CＩN发生率较对照组有下降趋势(３.08％比8．９3%,P＞0．05)。
结论:对冠心病患者行冠状动脉介入治疗,术前应用普罗布考可能有保护肾功能，预防对比剂肾病的作用。
关键词对比剂肾病普罗布考介入治疗Prｅvｅntiｏn Role ofＰroｂucｏl on Contrast-ｉnｄuced Ｎe ｐhrｏｐathy after Cｏronary AｎｇioplaｓtyＴｉan ｊin CｈｅsｔHｏｓpital Ｄong Jｕn Liu YiｎＳuｎGeｎyi Ａbｓtrａct Objｅctiｖe:To studｙthe rｏle of ｐrobｕcol on CIＮin patiｅｎtｓof coｒonａry aｔｈeroｓｃlerotｉc ｈｅａｒt disease（CＨD）undｅｒｇoiｎｇcoｒonary angioｐlａsｔy.Ｍeｔｈods: One ｈunｄｒeｄｔwenｔy ｏne hospitaliｚｅd pa ｔｉeｎｔｓoｆCHDｗiｔｈhyｐertenｓｉｏn undｅrgoing coronａry aｎｇｉopｌａsｔy weｒeｅnroｌleｄｔoｔhe stｕdy.Ｐatｉeｎts were raｎdomly diｖided ｔo ｐroｂucｏl groｕp(n=6５) or coｎtｒoｌgroｕp（n=56）. In thｅprｏbｕｃol group, ｔhe paｔｉｅnts received probuｃol ｔablets 375mg ｂid fｏｒ2 days beforeｐrocedure ａnd contｉnueｄto ｕｓe probucol ３daysａfter pｒｏcedure. The baｓｅlinｅclinic ａl,biｏchｅmical，aｎd pｒoceｄuｒal ｃhaｒactｅriｓticｓwerｅcollｅctｅd ｐrosｐｅctiｖｅly bｅforｅthe ａngiｏplaｓｔy, and ｆoｌlow－ｕp sｅrｕm creatinine weｒe ｍｅasurｅd 72 h afteｒanｇioplastｙ. Basｅline and fｏlloｗ-up gｌｏmｅrｕｌar filtration rate(eGFR）ｗerｅestimatedｕsｉng the Moｄifｉｅd Dｉet iｎRenａl Disea ｓeｓtｕｄy（ＭDＲD) foｒmula. We anaｌｙｚｅｄａnd compared thｅiｎcidence of CIN afteｒａngioｐｌａｓty，the chanｇe of ｓerum creatｉｎｉｎe，and ｅGFRｂｅtwｅeｎｔｈe twｏgｒoups.Results:Tｈere wｅｒe no siｇnｉficａnt ｄｉfｆeｒenceｓaｔbａseｌiｎe in majoritｙmｅaｓｕrｅｄparametersｂｅtwｅen tｗｏｇr ｏｕps．Ｓerｕｍｃreatinine, eGFR after angiｏpｌaｓtyｗere unchanging comparｅd ｔo prｅ－prｏceduｒe in the proｂucｏlｇｒoｕp. eGFR levｅl decｒeased from(８3.1±1９．8)to (76．2±1７.9)mL/mｉｎin contｒol gｒoup （P<0．05), Sｃｒlevｅl increase ｄfrom (8２.8±13.5) tｏ(9８．７±１7．1)µmｏl/L（P＜0.05)．In the coｎtrｏl ｇｒoup, tｈe pｏst-pｒｏｃedure Sｃr(ΔScr) inｃreased signiｆiｃantlｙfrom basｅline(P<0.05), eGＦR decreasｅd siｇnificaｎtly(P＜0.05).Tｈe ｉncｉdenｃe rａte of CＩN iｎproｂuｃoｌgroup was sligｈｔlｙlowｅr tｈan thaｔin coｎｔrol ｇｒoup（３．０8%vs８.９3％，P>０.05）. Cｏncluｓion:Usiｎg ｐｒobuｃoｌto treaｔｐatientｓof CHD before coｒonary ａnｇioplasty hａs potｅｎtial proteｃｔｉve efｆeｃｔon tｈe ｒeｎal fuｎction.Kｅｙｗoｒds cｏntraｓt－inducｅd nephropaｔhy probucol angｉoplaｓty对比剂肾病( cｏｎtraｓt induced nephｒｏpａthy,CIN)是冠状动脉内介入治疗的一种严重并发症, 使患者永久性肾功能损害及住院死亡率明显增加。
DOI：10.3969/j.issn.1007-5410.2013.01.022基金项目：国家自然科学基金资助项目（30900618）作者单位：300211天津医科大学第二医院心脏科天津心脏病学研究所通讯作者：刘彤，电子信箱：liutongdoc@；李广平，电子信箱：tjcardiol@ ·综述·普罗布考在心血管疾病中的应用进展邵帅刘彤富华颖李广平【关键词】普罗布考；心血管疾病；进展Application of probucol in the cardiovascular disease SHAO Shuai，LIU Tong，FU Hua-ying，LI Guang-ping. Department of Cardiology，the Second Hospital of Tianjin Medical University，Tianjin300211，ChinaCorresponding author：LIU Tong，Email：liutongdoc@ ；LI Guang-ping，Email：tjcardiol@ This work was supported by a grant from Natural Science Foundation of China（30900618）【Key words】Probucol；Cardiovascular disease；Progress普罗布考（probucol），化学名为丙丁酚，化学式为4，4'-［（1-甲基亚乙基）二双］2，6-二（1，1-二甲基乙基）苯酚，于20世纪70年代首先于美国上市并应用于临床，以往认为其主要作用是降低血清胆固醇。
近年来研究发现，普罗布考除具有降脂作用外，还具有抗动脉粥样硬化（atherosclerosis，AS）、抗氧化应激、保护血管内皮、预防对比剂急性肾损害（contrast induced acute kidney injury，CIAKI）及抗心律失常等作用，且能够预防经皮冠状动脉介入治疗（PCI）术后再狭窄。
阿托伐他汀联合普罗布考改善对比剂急性肾损伤的临床观察王一然;李曦铭;张迎怡;李作成;肖健勇;丛洪良【期刊名称】《天津医药》【年(卷),期】2011(39)1【摘要】目的:观察术前联用不同剂量阿托伐他汀与普罗布考对对比剂急性肾损伤(CIAKI)的影响.方法:149例接受择期冠状动脉造影(CAG)或经皮冠状动脉支架植入术(PCI)的冠心病患者,随机分为标准剂鼍组46例,阿托伐他汀每晚顿服20mg及普罗布考250mg,3次/d;强化联合组47例,阿托伐他汀每晚服40mg及普罗布考250mg,3次/d,术前2 h顿服阿托伐他汀40 mg普罗布考500 mg;强化剂量组56例,阿托伐他汀每晚顿服40 mg,术前2 h顿服阿托伐他汀加40mg.所有患者均于术前和术后24 h抽取静脉血检测尿素氮(BUN)、肌酐(Ser)、肾素全项,MDRD方法估算肾小球滤过率(eGFR).结果:(1)与术前比较,标准剂量组术后Scr升高,eGFR 下降,AngⅡ升高(P＜0.05);强化联合组术后BUN和AngⅡ下降.强化剂量组术后BUN下降(P＜0.05或P＜0.01),Scr及eGFR差异无统计学意义.(2)强化联合组Scr 下降值(△Scr)及△AngⅡ高于标准剂量组(P＜0.05).(3)对于肾功能轻中度损伤患者,强化联合组△Scr和△BUN高于其他2组(P＜0.05).结论:阿托伐他汀联合普罗布考强化或单用阿托伐他汀强化均可改善CIAKI,对于肾功能轻中度损伤患者,强化联合治疗改善作用显著.%Objective: To observe the effects of different doses of atorvastatin combined with probucol on contrast-induced acute kidney injury (CIAKI)before coronary angiography(CAG) or percutaneous coronary intervention(PCI). Methods:One hundred and forty-nine cases were randomly divided into 3 groups, standard combined treatment group (n =46, atorvastatin 20 mg/d, 1 time/d and probucol 250 mg/d,3 times/d; intensively combined treatment group (rn= 47, atorvastatin 40 mg/d,1 time/d,and probueol 250 mg/d,3 times/d, intaking bolus of atorvastatin 40 mg/d,l time/d and probucol 500 mg 2 hours before intervention; intensive atorvastatin therapy group (n= 56, atorvastatin 40 d,1 iine/d, bolus intaking atorvastatin 40 mg 2 hours before procedure. The values of urea nitrogen (BUN), serum creatinine (Scr), and all items rennin were detected before angioplasty and 24 h after angioplasty in patients of 3 groups. The level of glomerular filtration rate (eGFR) was estimated using the MDRD formula. Results: (1) After angioplasty, the levels of Scr and Ang Ⅱ increased significatly, but eGFR decreased significantly in standard combined treatment group(P ＜0.05). The levels of BUN and Ang Ⅱ decreased remarkably in intensively combined treatment group after angioplasty (P ＜ 0.05 or P ＜ 0.01), while no significant difference in values of Scr and eGFR. (2)The valuer of Δ Set and ΔAng Ⅱ were higher in intensively combined treatment group than those of standard combined treatment group (P ＜ 0.05). (3)For the patients of mild to moderate renal function, the walues of Δ Scr and Δ BUNwere significantly- higher in intensively combined treatment group than those of the other two groups(P ＜ 0.05). Gonclusion:The combination of atorvastatin 40 mg and probueol 250 mg or atorvastatin 40 mg before angiography could improve CIAKI.For the patients of mild to moderate renal function, strengthen and combined treatment could improve significantly.【总页数】4页(P31-34)【作者】王一然;李曦铭;张迎怡;李作成;肖健勇;丛洪良【作者单位】300070,天津医科大学研究生院;天津市胸科医院心内四科;天津市胸科医院心内四科;天津市胸科医院心内四科;天津市胸科医院心内四科;天津市胸科医院心内四科【正文语种】中文【相关文献】1.普罗布考联合瑞舒伐他汀对糖尿病大鼠对比剂急性肾损伤保护作用的研究 [J], 曹媛2.普罗布考联合阿托伐他汀预防对比剂肾损害80例 [J], 王审;陈云鹏;董志兵;林文辉;张济富3.前列地尔联合强化阿托伐他汀预防糖尿病肾病患者对比剂急性肾损伤的临床研究[J], 刘超;李强;刘彦;吴伟利;胡晴;周晓映4.普罗布考片联合阿托伐他汀钙片与单用阿托伐他汀钙片对大动脉粥样硬化型脑梗死治疗的效果对比分析 [J], 陈萌5.普罗布考联合阿托伐他汀对冠心病并发糖尿病介入治疗患者对比剂急性肾损害的影响 [J], 赵志国;孔令朝因版权原因，仅展示原文概要，查看原文内容请购买。
