| Objective:To observe the effects of probucol and trimetazidine on myocardial injury, inflammation and endothelial function in patients with unstable angina pectoris (UAP) underwent percutaneous coronary intervention (PCI), and investigate the probable mechanism of probucol and trimetazidine.Methods:154patients with UAP randomly divided into probucol group (56cases), trimetazidine group (37cases) and control group (61cases). Standard medical therapies were given in all154patients. The creatine kinase MB (CK-MB), cardiac troponin I (cTnI), heart-type fatty acid-bindling protein (h-FABP), high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) were measured in all enrolled subjects before PCI right time and at6:00in the next day morning after PCI, and heart-type fatty acid-bindling protein (h-FABP) was also measured in another control group before PCI right time,in3hours,6hours and more than10hours after PCI.Results:①The value of CRP before and after PCI of control group were3.86±1.99mg/L,4.74±2.36mg/L respectively (p<0.05). Those of probucol group were7.28±5.64mg/L,7.49±6.73mg/L respectively (p>0.05). Those of trimetazidine group were4.52±2.37mg/L,5.55±3.68mg/L respectively (p>0.05).②The value of NO before and after PCI of control group were78.50±33.75μmol/L,54.31±24.97μmol/L respectively (p<0.05). Those of probucol group were57.78±25.85μmol/L,56.62±27.52μmol/L respectively (p>0.05). Those of trimetazidine group were60.53±26.87μmol/L,60.46±39.19μmol/L respectively (p>0.05).③The value of Δ CRP of control group, probucol group and trimetazidine group were0.88±1.80mg/L,0.2±2.72mg/L,0.08±2.52mg/L respectively (p<0.05). The value of ΔNO of control group, probucol group and trimetazidine group were-24.19±25.85μmol/L,-1.16±28.58μmol/L,-0.07±27.90μmol/L respectively (p<0.05).④The value of CK-MB before and after PCI of control group were11.25±3.74U/L,16.02±11.01U/L respectively (p<0.05). Those of probucol group were11.21±4.84U/L,18.23±13.17U/L respectively (p<0.05). Those of trimetazidine group were13.45±3.06U/L,13.68±8.87U/L respectively (p>0.05).⑤The value of cTnI before and after PCI of control group were0.05±0.18ng/ml,0.47±0.19ng/ml respectively (p<0.05). Those of probucol group were0.09±0.07ng/ml,0.70±0.44ng/ml respectively (p<0.05). Those of trimetazidine group were0.16±0.37ng/ml,0.22±0.14ng/ml respectively (p>0.05).⑥The value of h-FABP before and after PCI in more than10hours of control group were0.84±0.98ng/ml,0.90±1.04ng/ml respectively (p>0.05). Those of probucol group were1.32±1.21ng/ml,1.41±1.23ng/ml respectively (p>0.05). Those of trimetazidine group were1.09±0.97ng/ml,1.13±1.21ng/ml respectively (p>0.05).⑦The value of ΔCK-MB of control group, probucol group and trimetazidine group were4.77±13.73U/L,7.02±13.81U/L,0.23±2.60U/L respectively (p<0.05). The levels of ΔcTnI of control group, probucol group and trimetazidine group were0.42±0.78ng/ml,0.61±0.84ng/ml,0.06±0.37ng/ml respectively (p<0.05). The value of Δh-FABP of control group, probucol group and trimetazidine group were0.06±0.37ng/ml,0.09±1.23ng/ml,0.04±1.31ng/ml respectively (p>0.05).⑧The value of h-FABP of another control group of before PCI right time,3hours,6hours and more than10hours after PCI were0.18±0.09ng/ml,0.68±0.31ng/ml,0.71±0.04ng/ml,0.43±0.49ng/ml respectively (p<0.05).Conclusion:①PCI may cause some minor damage of myocardium and endothelial function, and also produce inflammatory reaction in patients with UAP.②Probucol therapy at least24hours before PCI can significantly reduce the inflammatory reaction, improve endothelial function and prognosis in patients with UAP, but there is no effect of contributing to reducing myocardial injury.③Trimetazidine therapy in more than24hours before PCI can significantly protect myocardium, also can reduce the inflammatory reaction and improve endothelial function and prognosis in patients with UAP. |
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