阿利西尤单抗对急性冠状动脉综合征患者冠状动脉周围脂肪组织、冠周FAI及炎性因子的影响研究  

Study on the effect of alirocumab on pericoronary adipose tissue,pericoronary fat attenuation index(fai)and inflammatory factors in patients with acute coronary syndrome

作　　者：周强 范晓丹 王丽丽 苗浩 王乐乐 王菁 张清队 郝骥 祁春梅 Zhou Qiang;Fan Xiaodan;Wang Lili;Miao Hao;Wang Lele;Wang Jing;Zhang Qingdui;Hao Ji;Qi Chunmei(Department of Cardiovascular Medicine,The Second Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China;不详)

机构地区：[1]徐州医科大学第二附属医院心内科,徐州221000

出　　处：《中国循证心血管医学杂志》2024年第11期1358-1361,1365,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：江苏省卫生计生委科研面上项目(H2018002);徐州市卫健委青年医学科技创新项目(XWKYHT20210566)。

摘　　要：目的探讨阿利西尤单抗对急性冠状动脉综合征(ACS)患者冠状动脉周围脂肪组织(PCAT)、冠状动脉周围脂肪衰减(FAI)指数的影响及其与炎性因子的关系。方法选取2022年1月至2023年1月于本院收治的ACS患者120例,按照是否接受阿利西尤单抗治疗分为观察组和对照组,每组各60例。两组患者均给予常规药物治疗,观察组在此基础上加用阿利西尤单抗75 mg,每两周皮下注射一次,连续治疗36周。比较两组患者治疗前后的临床资料、血脂水平、PCAT比值、FAI、血清炎性因子水平及治疗36周期间随访的主要不良心血管事件(MACE)发生率。结果两组患者治疗前的临床资料比较,无统计学差异(P>0.05)。治疗后,两组患者的血脂水平均有改善,但观察组的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组,高密度脂蛋白胆固醇(HDL-C)水平高于对照组,差异均有统计学意义(P<0.05)。观察组的PCAT比值及FAI均低于对照组,差异有统计学意义(P<0.05)。观察组的炎性因子水平[超敏C-反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、血清肿瘤坏死因子-α(TNF-α)]均低于对照组,差异有统计学意义(P<0.05)。观察组的MACE发生率为3.3%,显著低于对照组的15.0%(P<0.05)。PCAT比值与血hs-CRP、IL-1β、IL-6、TNF-α水平呈正相关(r=0.612,r=0.481,r=0.578,r=0.543,P均<0.05)。结论阿利西尤单抗能够有效降低ACS患者的LDL-C水平,改善冠状动脉周围脂肪组织的代谢状态,抑制炎症反应,从而降低心血管事件的风险。Objective To investigate the impact of Alirocumab on pericoronary adipose tissue(PCAT)and the pericoronary adipose tissue attenuation index(FAI)in patients with acute coronary syndrome(ACS),as well as its relationship with inflammatory factors.Methods A total of 120 ACS patients admitted to our hospital from January 2022 to January 2023 were selected.They were divided into the observation group(60 cases)and the control group(60 cases)based on whether they received Alirocumab treatment.Both groups received conventional medication,and the observation group additionally received subcutaneous injections of Alirocumab at a dose of 75 mg every two weeks for a continuous treatment period of 36 weeks.Clinical data,lipid levels,PCAT ratio,FAI,serum inflammatory factor levels,and the occurrence rate of major adverse cardiovascular events(MACE)during the 36-week follow-up were compared between the two groups before and after treatment.Results There were no statistically significant differences in clinical data between the two groups before treatment(P>0.05).After treatment,both groups showed improved lipid levels,but the observation group had significantly lower levels of total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C),and higher levels of high-density lipoprotein cholesterol(HDL-C)compared to the control group(P<0.05).The PCAT ratio and FAI in the observation group were lower than those in the control group,with statistical significance(P<0.05).The levels of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),interleukin-6(IL-6),and serum tumor necrosis factor-α(TNF-α)]in the observation group were lower than those in the control group,with statistical significance(P<0.05).The occurrence rate of MACE in the observation group was 3.3%,significantly lower than the 15.0%in the control group(P<0.05).The PCAT ratio was positively correlated with serum hs-CRP,IL-1β,IL-6,and TNF-αlevels(r=0.612,r=0.481,r=0.578,r=0.543,P<0.05).Conclusion Alirocumab eff

关 键 词：急性冠脉综合征 冠状动脉周围脂肪组织 FAI指数 阿利西尤单抗 炎性因子 

分 类 号：R543.3[医药卫生—心血管疾病]