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作 者:夏小花 郝应禄[1] 李燕萍[1] 余子阳 李玺臣 李兰新 XIA Xiaohua;HAO Yinglu;LI Yanping;YU Ziyang;LI Xichen;LI Lanxin(Department of Cardiovascular Medicine,Yuxi People's Hospital/Sixth Affiliated Hospital of Kunming Medical University,Yuxi Yunnan 653100,China)
机构地区:[1]玉溪市人民医院/昆明医科大学第六附属医院心血管内科,云南玉溪653100
出 处:《云南医药》2024年第4期20-23,共4页Medicine and Pharmacy of Yunnan
基 金:国家自然科学基金项目(82060062);云南省医学领军人才项目(L-2017007);云南省科技厅昆医联合专项(202001AY070001-167,202101AY070001-200)。
摘 要:目的分析PCSK9抑制剂联合他汀治疗在冠心病患者中对血脂、炎症因子和颈动脉斑块的影响。方法应用前瞻性随机对照研究,纳入2022年9月-2022年12月期间在玉溪市人民医院心内科诊断为冠心病合并高脂血症的101例患者,随机分为2组,观察组50例,使用阿利西尤单抗加他汀类药物治疗,对照组51例,使用他汀类药物治疗,持续治疗6个月。对比2组患者治疗6个月后血脂、炎症指标、颈部血管斑块Crouse积分的变化情况;比较整个随访阶段2组患者不良心血管事件及不良反应的发生情况。结果治疗6个月后,观察组的TC、TG、LDL-C、ApoB、Lp(a)、hs-CRP、IL-6、PLR、NLR水平及颈动脉斑块的Crouse积分均较治疗前下降,降幅明显高于对照组,HDL-C升幅及LDL-C达标率均高于对照组,差异有统计学意义(P<0.05);2组不良反应和心血管不良事件发生率比较差异无统计学意义(P>0.05)。结论PCSK9抑制剂联合他汀治疗可在短期内可以快速改善冠心病患者血脂水平、体内炎症反应和斑块稳定性,在短期应用中安全性良好。Objective To analyze the effects of PCSK9 inhibitor combined with statin on blood lipids,inflammatory factors and carotid plaque in patients with coronary heart disease.Methods A prospective randomized controlled study was conducted to include 101 patients diagnosed with coronary heart disease combined with hyperlipidemia in the Cardiology Department of Yuxi People's Hospital from September 2022 to December 2022,and they were randomly divided into two groups:observation group(50 cases)was treated with aliciumab plus statins,and control group(51 cases)was treated with statins.Treatment continued for six months.The changes of blood lipids,inflammatory indicators and cervical vascular plaque Crouse scorse of neckl vascular plaques were compared between the two groups after six months of treatment.The incidence of adverse cardiovascular events and adverse reactions were compared between the two groups during the whole follow-up period.Results After 6 months of treatment,the levels of TC,TG,LDL-C,ApoB,Lp(a),hs-CRP,IL-6,PLR,NLR and Crouse scores of carotid plaque in the observation group were all decreased compared with those before treatment,and the decrease rate was significantly higher than those of the control group,the increase rate HDL-C and rate of reaching the standard were all higher than those of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions and cardiovascular adverse events between the two groups(P>0.05).Conclusions PCSK9 inhibitor combined with statin therapy can rapidly improve blood lipid level,inflammatory and plaque stability in patients with coronary heart disease in the short term,and it is safe in short-term application.
关 键 词:冠状动脉粥样硬化性心脏病 PCSK9抑制剂 血脂 炎症因子
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