急性冠脉综合征患者PCI围手术期应用依洛尤单抗的疗效研究  

Efficacy of perioperative use of evolocumab on patients with acute coronary syndrome undergoing percutaneous coronary intervention

作　　者：谢亚囡[1] 康少伟[1] 焦薇 郝玉明[1] 祖秀光[1] XIE Yanan;KANG Shaowei;JIAO Wei(Department of Cardiology,the Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院心内科,石家庄市050000

出　　处：《河北医药》2023年第20期3102-3106,共5页Hebei Medical Journal

基　　金：河北省卫生健康委员会医学科学研究重点课题(编号:20211523)。

摘　　要：目的探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗术(PCI)围手术期应用依洛尤单抗的疗效。方法选取2022年1月至2022年6月住院行PCI治疗且血脂不达标的急性冠脉综合征患者100例,随机分为试验组及对照组,每组50例,对照组给予中等剂量他汀治疗,试验组于PCI术后2 h内在他汀治疗基础上联合依洛尤单抗140 mg皮下注射,2周1次,随访1个月,比较2组治疗前后血脂水平变化、药物不良反应及1个月MACE事件发生率。结果本试验最终纳入患者97例,年龄(62.8±8.0)岁,男54例(55.7%),试验组49例,对照组48例。试验组1个月LDLC中位数由基线的3.31 mmol/L降至1.53 mmol/L,降幅均数为53.9%,与对照组比较差异有统计学意义(P<0.01);1个月试验组LDLC≤1.80 mmol/L以及≤1.40 mmol/L的患者比例明显高于对照组(P<0.01);对照组1个月Lp(a)较基线升高12.6%,而试验组较基线下降27.4%;与对照组相比,1个月试验组Apo B、空腹三酰甘油和总胆固醇较基线的降幅更为显著(P均<0.01);1个月HDLC及Apo A2组均有所升高,但差异无统计学意义(P>0.05)。治疗期间试验组发生严重不良心血管事件的患者比例低于对照组(P<0.05),而不良反应2组无明显差异(P>0.05)。结论急性冠脉综合征患者PCI围手术期在中等剂量他汀治疗基础上联合应用依洛尤单抗可有效迅速降低血脂水平,可能降低短期心血管事件发生率且总体安全性良好。Objective To investigate the efficacy of perioperative use of evolocumab during on patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Methods A total of 100 consecutive eligible ACS inpatients with abnormal blood lipids undergoing PCI from January 2022 to June 2022 were selected.Patients were randomly assigned to the control group and study group,with 50 cases per group.All patients were given moderate-dose statin within 2 hours of PCI,and those in the study group were additionally given subcutaneous injection of evolocumab 140mg once every 2 weeks.All the patients were followed up for 1 month.Changes in blood lipid levels,adverse drug reactions and the incidence of major adverse cardiovascular events(MACEs)were compared between the two groups.Results A total of 97 eligible patients were finally recruited,involving 49 in the study group and 48 in the control group.Among them,there were 54(55.7%)male patients,and the mean age of the cohort was(62.8±8.0)years.The median low-density lipoprotein cholesterol(LDL-C)in the study group at 1 month dropped from 3.31mmol/L at baseline to 1.53mmol/L,with a mean decrease of 53.9%,which was significant different between study group and control group(P<0.01).The proportion of patients with LDL-C≤1.80mmol/L(71.4%vs 37.5%)and≤1.40mmol/L(48.9%vs 10.4%)in the study group at 1 month was significantly higher than that of control group(both P<0.01).Lipoprotein(a)(Lp[a])in the control group increased by 12.6%(-7.9%,19.8%)at 1 month compared with the baseline,which,in the study group decreased by-27.4%(-38.4%,-8.9%)compared with the baseline.Compared with those of control group,reductions of Apolipoprotein B(Apo B),fasting triacylglycerol(FTG)and total cholesterol(TC)at 1 month than those of baseline were significantly pronounced in the study group(all P<0.01).At 1 month of treatment,high-density lipoprotein cholesterol(HDL-C)and Apolipoprotein A2(Apo A2)were enhanced in both groups,but significant differences were not detectable(P>0.05).Th

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 依洛尤单抗 血脂 不良心血管事件 

分 类 号：R543.3[医药卫生—心血管疾病]