阿利西尤单抗联合他汀类药物治疗对急性冠脉综合征患者血脂水平和短期预后的影响  

Effects of alirocumab combined with statin therapy on blood lipid levels and short-term prognosis in patients with acute coronary syndrome

作　　者：程国杰[1] 曹树军[1] 张银 汤玮[1] 佟子川[1] CHENG Guo-jie;CAO Shu-jun;ZHANG Yin(Department of Cardiology,Daxing Hospital of the Capital Medical University,Beijing 102600,China)

机构地区：[1]首都医科大学大兴医院心内科,北京102600

出　　处：《临床和实验医学杂志》2023年第11期1140-1144,共5页Journal of Clinical and Experimental Medicine

基　　金：首都卫生发展科研专项(编号:首发2020-3-7122)。

摘　　要：目的评价阿利西尤单抗联合他汀类药物治疗对急性冠脉综合征(ACS)患者血脂水平和短期预后的影响。方法回顾性选取2021年7月至12月在首都医科大学大兴医院就诊的ACS患者共115例为研究对象,根据患者的降脂方案,将其分为他汀组(n=60)和阿利西尤单抗组(n=55)。他汀组单独应用瑞舒伐他汀10 mg,每晚1次口服,阿利西尤单抗组在他汀组的基础上加阿利西尤单抗75 mg,每两周1次皮下注射。疗程均为6个月。对患者进行为期6个月的随访,观察两组患者治疗前、治疗6个月后血脂[总胆固醇、低密度脂蛋白胆固醇(LDL-C)、总胆固醇降幅、LDL-C降幅、LDL-C达标率、LDL-C降幅大于50%的达标率]变化和主要不良心血管事件发生情况。结果阿利西尤单抗组患者治疗前总胆固醇和低密度脂蛋白胆固醇(LDL-C)水平分别为(5.63±1.25)、(3.92±1.05)mmol/L,均高于他汀组[(4.88±0.46)、(3.17±0.43)mmol/L],差异均有统计学意义(P<0.05)。治疗6个月后,阿利西尤单抗组患者LDL-C水平为(1.36±0.34)mmol/L,明显低于他汀组[(1.93±0.41)mmol/L],差异有统计学意义(P<0.05)。治疗后,阿利西尤单抗组总胆固醇降幅、LDL-C降幅、LDL-C达标率、LDL-C降幅大于50%的达标率分别为(58.32±11.02)%、(65.86±10.79)%、76.36%、90.91%,均明显高于他汀组[(35.47±14.38)%、(40.32±12.88)%、31.67%、30.00%],差异均有统计学意义(P<0.05)。出院后6个月阿利西尤单抗组因心绞痛再次住院、非靶血管血运重建率分别为7.27%、7.27%,均明显低于他汀组(33.33%、30.00%),差异均有统计学意义(P<0.05)。结论阿利西尤单抗联合他汀治疗明显降低ACS患者LDL-C水平,提高LDL-C达标率,改善患者短期预后。Objective To evaluate the effects of alirocumab combined with statin therapy on blood lipid levels and short-term prognosis in patients with acute coronary syndrome.Methods A total of 115 patients with acute coronary syndrome who were treated in Daxing Hospital of Capital Medical University from July to December 2021 were retrospectively selected as the research subjects.According to the lipid-lowering regimen of the patients,they were divided into statin group(n=60)and alirocumab group(n=55).In the statin group,10 mg of rosuvastatin was administered orally once a night,while in the aliciumab group,75 mg of aliciumab was added on the basis of the statin group,which was administered subcutaneously once every two weeks.The treatment period was all 6 months.Follow up the patients for a period of 6 months to observe the changes in blood lipids[total cholesterol,low-density lipoprotein cholesterol(LDL-C),total cholesterol decrease,LDL-C decrease,LDL-C compliance rate,LDL-C compliance rate with 50%reduction]before and after treatment and the occurrence of major adverse cardiovascular events in both groups.Results The levels of total cholesterol and LDL-C in the aliciumab group before treatment were(5.63±1.25)and(3.92±1.05)mmol/L,respectively,which were higher than those in the statin group[(4.88±0.46)and(3.17±0.43)mmol/L],the differences were statistically significant(P<0.05).After 6 months of treatment,the level of LDL-C in the aliciumab group was(1.36±0.34)mmol/L,which was significantly lower than that in the statin group[(1.93±0.41)mmol/L],the difference was statistically significant(P<0.05).After treatment,the total cholesterol reduction,LDL-C reduction,LDL-C compliance rate,and LDL-C reduction greater than 50%in the aliciumab group were(58.32±11.02)%,(65.86±10.79)%,76.36%and 90.91%,respectively,which were significantly higher than those in the statin group[(35.47±14.38)%,(40.32±12.88)%,31.67%and 30.00%],and the differences were statistically significant(P<0.05).Six months after discharge,the rates of re-

关 键 词：他汀 前蛋白转化酶枯草溶菌素9抑制剂 阿利西尤单抗 急性冠脉综合征 血脂水平 预后 

分 类 号：R541.4[医药卫生—心血管疾病]