邹岩明++姚元英+李荣++辛辉

[摘要]目的 觀察瑞舒伐他汀联合普罗布考治疗动脉粥样硬化的效果。方法 收集2013年1月～2015年6月在我院治疗的冠180例心病患者作为研究对象。随机分为联合组、瑞舒伐他汀组和普罗布考组，各组均60例，治疗6个月。联合组给予瑞舒伐他汀联合普罗布考片治疗，瑞舒伐他汀组只给予瑞舒伐他汀口服，普罗布考组只给予普罗布考治疗。统计各组的治疗有效率，检测血清胆固醇、高密度脂蛋白及低密度脂蛋白水平，计算颈动脉内中膜厚度，评估三组的治疗效果。结果 联合组的总有效率显著高于瑞舒伐他汀组和普罗布考组，差异有统计学意义（P<0.05）；而瑞舒伐他汀组与普罗布考组的总有效率比较，差异无统计学意义（P>0.05）。联合组治疗前后的血总胆固醇、血高密度脂蛋白、低密度脂蛋白、颈动脉内中膜厚度比较，差异有统计学意义（P<0.05）。瑞舒伐他汀组治疗前后的血总胆固醇及血高密度脂蛋白水平比较，差异有统计学意义（P<0.05）。普罗布考组治疗前后的血低密度脂蛋白、颈动脉内中膜厚度比较，差异有统计学意义（P<0.05）。联合组治疗后的血低密度脂蛋白、颈动脉内中膜厚度与瑞舒伐他汀组比较，差异有统计学意义（P<0.05）。联合组治疗后的血总胆固醇、血高密度脂蛋白、颈动脉内中膜厚度与普罗布考组比较，差异有统计学意义（P<0.05）。瑞舒伐他汀组治疗后的血总胆固醇、血高密度脂蛋白、血低密度脂蛋白、颈动脉内中膜厚度与普罗布考组比较，差异有统计学意义（P<0.05）。结论 瑞舒伐他汀与普罗布考组联合治疗可有效抗动脉硬化，较单独给药可显著提高疗效，在临床中值得推广应用。

[关键词]瑞舒伐他汀；普罗布考；冠心病；临床效果

[中图分类号] R543 [文献标识码] A [文章编号] 1674-4721（2017）04（a）-0048-05

Clinical observation of Rosuvastatin combined with Probucol in the treatment of atherosclerosis

ZOU Yan-ming1 YAO Yuan-ying2 LI Rong3 XIN Hui4

1.Department of Internal Medicine-Cardiovascular，Weihaiwei People′s Hospital of Weihai City in Shandong Province，Weihai 264200，China；2.Department of Pediatrics，Maternal and Child Health Care Hospital of Huancui District of Weihai City in Shandong Province，Weihai 264200，China；3.Electrocardiographic Room，Medical College of Qingdao University，Qingdao 266000，China；4.Department of Internal Medicine-Cardiovascular，Affiliated Hospital of Medical College of Qingdao University，Qingdao 266000，China

[Abstract]Objective To obsreve the effect of Rosuvastatin combined with Probucol in the treatment of atherosclerosis.Methods 180 cases of coronary heart disease from January 2013 to June 2015 treated in our hospital were selected and randomly divided into the combination group，the Rosuvastatin group and the Probucola group，60 cases in each group.All of them were treated for 6 months.The combined group was treated with Rosuvastatin combined with Probucol Tablets，the Rosuvastatin group was only given Rosuvastatin，the Probucol group was only given Probucol.The effective rate of each group was measured，the levels of serum cholesterol，high density lipoprotein and low density lipoprotein were detected，and the intima-media thickness of carotid artery was calculated.The therapeutic effects of the three groups were evaluated.Results The total effective rate of the combined group was significantly higher than that of the Rosuvastatin group and the Rrobucol group，with significant difference （P<0.05）.There was no significant difference in total effective rate between the Rosuvastatin group and the Probucol group （P>0.05）.There was significant difference in the levels of total cholesterol，high-density lipoprotein，low-density lipoprotein and carotid intima-media thickness of the combined group before and after treatment （P<0.05）.There was significant difference in the level of serum total cholesterol and high density lipoprotein cholesterol before and after treatment in the Rosuvastatin group （P<0.05）.There was significant difference in the level of low density lipoprotein and carotid intima media thickness in the Probucol group before and after treatment （P<0.05）.There was significant difference in the level of low density lipoprotein and carotid intima media thickness after treatment between the combined group and the Rosuvastatin group （P<0.05）.There was significant difference in the level of the total cholesterol，high density lipoprotein and carotid intima-media thickness after treatment between the combined group and the Probucol group （P<0.05）.There were significant differences in the level of total cholesterol，high density lipoprotein，low density lipoprotein and carotid intima media thickness after treatment between the Rosuvastatin group and the Probucol group （P<0.05）.Conclusion Rosuvastatin conbined with Probucol can effectively inhibit atherosclerosis，compared with a single drug，which can significantly improve the efficacy，it is worthy of promotion and application in clinical practice.

[Key words]Rosuvastatin；Probucol；Coronary heart disease；Clinical effect

近年来，冠状动脉粥样硬化性心脏病的病死率、致残率极高，已得到越来越多的重视。血脂异常是冠心病发病的危险因素之一。以往大量研究资料已表明，血脂水平异常与冠心病密切相关[1]。血脂异常对冠心病发生及严重程度在时间上有累积效应，且易致阿司匹林抵抗，从而成为冠脉病变的独立预测因子[2]，因此研究两者之间的关联、优化治疗具有重大意义。

2007年原卫生部《中国成人血脂异常防治指南》[3]以及2011年欧洲心脏病学会（European Society of Cardiology，ESC）、欧洲动脉粥样硬化学会（European Athrosclerosis Society，EAS）血脂异常指南[4]均指出，血脂异常的首要治疗目标在于提高高密度脂蛋白，降低总胆固醇、三酰甘油及低密度脂蛋白的水平，稳定冠状动脉的脂质斑块，防止扩大。……