依洛尤单抗对急性心肌梗死患者心肌缺血再灌注损伤的作用研究  

Effect of evolocumab on myocardial ischemia-reperfusion injury in patients with acute myocardial infarction

作　　者：李里 孟凡同 韩冰[1] Li Li;Meng Fantong;Han Bing(Department of Cardiology,Central Hospital of Xuzhou City,Xuzhou 221000,China;不详)

机构地区：[1]徐州市中心医院心内科,徐州221000 [2]徐州市中心医院中心实验室,徐州221000

出　　处：《中国循证心血管医学杂志》2024年第11期1394-1397,1405,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的研究依洛尤单抗对急性心肌梗死(AMI)患者心肌缺血再灌注损伤(MIRI)的作用。方法回顾性选取2020年6月至2023年6月于徐州市中心医院进行急诊经皮冠状动脉介入治疗(PCI)的AMI患者244例,根据术后用药分为常规组(n=146)和依洛尤单抗组(n=98),常规组于PCI术后予以常规药物治疗,依洛尤单抗组于术前10 min皮下注射1次负荷剂量(420 mg)依洛尤单抗,术后每2周注射标准剂量(140 mg/次),其他治疗同常规组,两组患者均持续药物干预3月。记录两组患者术前后血脂、炎性因子、血管内皮功能、心肌损伤指标、心脏功能指标、心电图变化及术后3月MIRI相关总不良事件发生情况。结果PCI术后6 h,依洛尤单抗组三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均低于常规组,高密度脂蛋白胆固醇(HDL-C)水平高于常规组(P<0.05);依洛尤单抗组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平低于常规组(P<0.05);依洛尤单抗组血清内皮素-1(ET-1)、血管性血友病因子(vWF)水平低于常规组,一氧化氮(NO)水平高于常规组(P<0.05);依洛尤单抗肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-ProBNP)、左心室舒张末期内径(LVED)水平低于常规组,左室射血分数(LVEF)、每博心输出量(SV)水平高于常规组(P<0.05)。依洛尤单抗组PCI术后10 min,ST段抬高幅度低于常规组(P<0.05)。依洛尤单抗组PCI术后3月MIRI相关总不良事件发生率低于常规组(4.08%vs.11.64%),(P<0.05)。结论依洛尤单抗可有效降低AMI患者血脂水平,下调炎性因子,保护血管内皮功能,促进心脏功能恢复,对减轻MIRI具有积极意义。Objective To study the effect of evolocumab on myocardial ischemia-reperfusion injury(MIRI)in patients with acute myocardial infarction(AMI).Methods AMI patients(n=244)undergone emergency percutaneous coronary intervention(PCI)were retrospectively chosen from Central Hospital of Xuzhou City from June 2020 to June 2023,and divided,according to medicinal administration,into routine group(n=146)and evolocumab group(n=98).The routine group was treated with routine medicinal after PCI,and evolocumab group was additionally given hypodermic injection of evolocumab in loading dose once(420 mg)10 min before PCI,and in standard dose(140 mg/time)after 2 weeks for 3 months.The changes of blood fat,inflammatory factors,vascular endothelial function,myocardial injury indexes,heart function indexes and electrocardiogram(ECG),and the total occurrence rates of adverse events related to MIRI were recorded in 2 groups before and after PCI.Results After PCI for 6 h,the levels of triglyceride(TG),total cholesterol(TC)and low-density lipoprotein-cholesterol(LDL-C)were lower,and kevel of high-density lipoprotein-cholesterol(HDL-C)was higher in evolocumab group than those in routine group after PCI for 6 h(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)were lower in evolocumab group than those in routine group(P<0.05).The levels of serum endothelin-1(ET-1)and von Willebrand factor(vWF)was lower,and level of nitric oxide(NO)was higher in evolocumab group than those in routine group(P<0.05).The levels of creatine kinase-MB isoenzyme(CK-MB),cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP)and left ventricular end-diastolic diameter(LVEDD)were lower,and left ventricular ejection fraction(LVEF)and stroke volume(SV)were higher in evolocumab group than those in routine group(P<0.05).The amplitude of ST-segment elevation was lower in evolocumab group than that in routine group 10 min after PCI(P<0.05).After PCI for 3 months,the total occurrence

关 键 词：急性心肌梗死 心肌缺血再灌注损伤 依洛尤单抗 不良事件 

分 类 号：R542.22[医药卫生—心血管疾病]