依洛尤单抗联合阿托伐他汀对老年冠心病患者的作用效果  

Effects of Evolocumab Combined with Atorvastatin on Elderly Patients with Coronary Heart Disease

作　　者：徐晓晨 王全河 靳梁羽 XU Xiaochen;WANG Quanhe;JIN Liangyu(Department of Cardiology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China;Emergency Department,Zhengzhou People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学附属郑州中心医院心血管内科,河南郑州450007 [2]郑州人民医院急诊科,河南郑州450003

出　　处：《河南医学研究》2024年第22期4146-4150,共5页Henan Medical Research

摘　　要：目的探讨依洛尤单抗联合阿托伐他汀对老年冠心病(CHD)患者血管内皮功能及血清可溶CD40配体(sCD40L)、脂蛋白相关磷脂酶A2(Lp-PLA2)、Apelin水平的影响。方法采用随机数字表法将2021年1月至2022年9月在郑州大学附属郑州中心医院接受治疗的204例老年CHD患者分为A组和B组,各102例。A组接受常规治疗和阿托伐他汀钙片,B组在A组基础上接受依洛尤单抗注射液。两组均持续治疗6个月。比较治疗6个月后的临床疗效,治疗前、治疗6个月后的血管内皮功能、血清sCD40L、Lp-PLA2、Apelin水平、血脂指标及心功能参数,治疗期间的不良反应。结果B组治疗6个月后的总有效率为93.14%,高于A组的78.43%(P<0.05)。与治疗前比较,治疗6个月后,两组血清内皮素1(ET-1)、sCD40L、Lp-PLA2、Apelin、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a[Lp(a)]水平均降低,且与A组比较,B组较低;两组血清一氧化氮(NO)、血管内皮生长因子(VEGF)水平、血流介导的血管扩张功能(FMD)、左室射血分数(LVEF)、心脏指数(CI)均升高,且与A组比较,B组较高(P<0.05)。B组治疗期间的不良反应发生率低于A组(P<0.05)。结论依洛尤单抗可调节老年CHD患者血脂指标,提高患者心功能及血管内皮功能,调节血清sCD40L、Lp-PLA2、Apelin水平,进而可提高临床疗效,且具有较高安全性。Objective To investigate the effects of evolocumab combined with atorvastatin on vascular endothelial function and the levels of serum soluble CD40 ligand(sCD40L),lipoprotein related phospholipase A2(Lp-PLA2)and Apelin in elderly patients with coronary heart disease(CHD).Methods A total of 204 elderly patients with CHD who received treatment at Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to September 2022 were divided into the group A and the group B by random number table method,102 cases in each group.The group A was given routine treatment and Atorvastatin calcium tablets,and the group B was given evolocumab injection on the basis of the group A.Both groups continued treatment for 6 months.The clinical efficacy after 6 months of treatment,including vascular endothelial function,the levels of serum sCD40L,Lp-PLA2,Apelin,blood lipid indicators and cardiac function parameters before and after 6 months of treatment,the safety during the treatment period were compared of two groups.Results The rate of total effective in the group B after 6 months of treatment was 93.14%,which was higher than 78.43%in the group A(P<0.05).Compared with before treatment,after 6 months of treatment,the levels of serum endothelin-1(ET-1),sCD40L,Lp-PLA2,Apelin,low-density lipoprotein cholesterol(LDL-C)and lipoprotein a[Lp(a)]in both groups decreased,and compared with the group A,the group B was lower.The levels of serum nitric oxide(NO),vascular endothelial growth factor(VEGF),flow mediated vasodilation(FMD),left ventricular ejection fraction(LVEF),and cardiac index(CI)in the two groups increased,and compared with the group A,the group B was higher(P<0.05).The incidence of adverse reactions in the group B during the treatment period was lower than the group A(P<0.05).Conclusion Evolocumab could significantly regulate blood lipid indicators in elderly patients with CHD,improve cardiac and vascular endothelial function,regulate the levels of serum sCD40L,Lp-PLA2,Apelin,and thereby improve clinical effica

关 键 词：冠心病 老年 依洛尤单抗 血管内皮功能 可溶CD40配体 脂蛋白相关磷脂酶A2 APELIN 

分 类 号：R541.4[医药卫生—心血管疾病]