依洛尤单抗对急性广泛前壁心肌梗死患者PCI术后血脂及左心室功能的影响  

Effects of evolocumab on blood lipid and left ventricular function in patients with acute extensive anterior myocardial infarction after percutaneous coronary intervention

作　　者：刘玉芝 吴淑丽 任玉华[1] 许宗磊[1] 刘涛[1] LIU Yuzhi;WU Shuli;REN Yuhua;XU Zonglei;LIU Tao(Department of Cardiology,Liaocheng People′s Hospital,Liaocheng 252000,China;Mengyin Daigu Town Center Hospital,Mengyin 276200,China)

机构地区：[1]聊城市人民医院心内科,聊城252000 [2]蒙阴县岱崮镇中心卫生院,蒙阴276200

出　　处：《济宁医学院学报》2024年第5期391-394,共4页Journal of Jining Medical University

摘　　要：目的探讨依洛尤单抗对急性广泛前壁心肌梗死经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后血脂和左心功能的影响。方法回顾性分析2021年1月至2023年7月于聊城市人民医院就诊的急性广泛前壁心肌梗死并行急诊PCI的患者52例,根据患者的术后的调脂方案分为两组,其中单纯服用瑞舒伐他汀者为对照组,共24例;联合瑞舒伐他汀和依洛尤单抗治疗者为观察组,共28例。分别于术前及术后6个月测定患者血总胆固醇(TC),甘油三酯(TG),低密度脂蛋白(LDL),高密度脂蛋白(HDL),C反应蛋白(CRP),B型钠尿肽(BNP)。行心脏彩超检查测定左室射血分数(LVEF),左室舒张末内径(LVEDD)。结果术后6个月,与对照组相比,观察组TC(3.28±0.73mmol/L vs 4.45±0.99mmol/L,t=-4.90,P<0.001)、TG(1.09±0.33mmol/L vs 1.61±1.07mmol/L,t=-2.44,P=0.02)、LDL(1.18±0.12mmol/L vs 2.05±0.35mmol/L,t=-11.59,P<0.001)、BNP(263.57±119.12pg/mL vs 575.58±219.99pg/mL,t=-6.21,P<0.001)、CRP(1.19±1.03mg/L vs 1.74±0.66mg/L,t=-2.23,P=0.02)明显降低,HDL(1.97±0.34mmo/L vs 1.66±0.29mmol/L,t=3.472,P=0.001)明显升高,LVEDD(35.57±2.83mm vs 40.83±4.35mm,t=-5.074,P<0.001)明显缩小,LVEF[(59.36±6.92%)vs(52.50±7.96%),t=3.32,P=0.002]明显升高。结论在急性广泛前壁心肌梗死中联合应用依洛尤单抗和他汀类药物可进一步显著降低患者的血脂和炎症水平,而且能进一步改善患者左心室功能。Objective To investigate the effect of evolocumab on left ventricular function after percutaneous coronary intervention(PCI)for acute extensive anterior myocardial infarction.Methods Fifty-two patients with acute anterior myocardial infarction and emergency PCI in Liaocheng People′s Hospital from January 2021 to July 2023 were collected.According to the postoperative lipid regulation scheme,the patients were divided into two groups:the control group(24 cases)treated with rosuvastatin alone;the observation group(28 cases)treated with rosuvastatin combined with evolocumab.The blood total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),C-reactive protein(CRP),and B-type natriuretic peptide(BNP)were measured before and 6 months after surgery.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)were measured by echocardiography.Results 6 months after surgery,compared with the control group,TC(3.28±0.73mmol/l vs 4.45±0.99mmol/l,t=-4.90,P<0.001)、TG(1.09±0.33mmol/l vs 1.61±1.07mmol/l,t=-2.44,P=0.02)、LDL(1.18±0.12mmol/l vs 2.05±0.35mmol/l,t=-11.59,P<0.001)、BNP(263.57±119.12pg/ml vs 575.58±219.99pg/ml,t=-6.21,P<0.001)、CRP(1.19±1.03mg/L vs 1.74±0.66mg/L,t=-2.23,P=0.02)in the observation group were significantly lower,HDL(1.97±0.34mmol/L vs 1.66±0.29mmol/L,t=3.47,P=0.001)was significantly increased,LVEDD(35.57±2.83mm vs 40.83±4.35mm,t=-5.07,P<0.001)was significantly reduced,and LVEF[(59.36±6.92)%vs(52.50±7.96)%,t=3.32,P=0.002]was significantly increased(P<0.05).Conclusions The combined application of evolocumab and statins in acute extensive anterior myocardial infarction can further significantly reduce the blood lipid and inflammatory levels of patients,and can further improve the left ventricular function of patients.

关 键 词：依洛尤单抗 急性广泛前壁心肌梗死 经皮冠状动脉介入治疗 左心室功能 

分 类 号：R541.4[医药卫生—心血管疾病]