PCSK9抑制剂早期应用对非ST段抬高型急性冠脉综合征患者的疗效研究  

Efficacy of early use of PCSK9 inhibitors in patients with non-ST-elevation acute coronary syndrome

作　　者：郑伟[1] 刘芳芳[2] 薛宇龙 高宇平[1] ZHENG Wei;LIU Fangfang;XUE Yulong;GAO Yuping(Department of Cardiovascular Medicine,The Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030032,China;Department of Nursing,The Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030032,China)

机构地区：[1]山西医科大学第三医院·山西白求恩医院·山西医学科学院·同济山西医院心血管内科,山西太原030032 [2]山西医科大学第三医院·山西白求恩医院·山西医学科学院·同济山西医院护理部,山西太原030032

出　　处：《西部医学》2024年第12期1786-1791,共6页Medical Journal of West China

基　　金：山西省重点研发计划项目(201903D321179)。

摘　　要：目的 旨在观察PCSK9抑制剂早期内应用对非ST段抬高型急性冠脉综合征患者的疗效。方法 选取2021年12月—2022年11月于山西白求恩医院心内科治疗的80例非ST段抬高型急性冠脉综合征患者,将其随机分为观察组(n=37)和对照组(n=43)。记录患者入院及治疗6个月后的血脂、炎症因子和血管内皮功能指标及主要不良心血管事件发生率。结果 治疗6个月后,与对照组相比,观察组的总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高敏C反应蛋白、IL-6水平明显下降(均P<0.05)。与对照组相比,观察组的血清内皮素1降低,一氧化氮水平升高(均P<0.05)。随访6个月内,观察组的不良心血管事件发生略低于对照组(P<0.05)。结论 在非ST段抬高型急性冠脉综合征患者中,早期应用PCSK9抑制剂能够迅速降低血脂水平,减轻炎症反应,改善血管内皮功能,并降低主要不良心血管事件的风险。Objective This study aimed to evaluate the efficacy of early use of PCSK9 inhibitors on serum lipid levels,inflammatory markers,endothelial function,and the incidence of major adverse cardiovascular events(MACE)in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS).Methods We enrolled 80 NSTE-ACS patients treated at the Department of Cardiovascular Medicine,Shanxi Bethune Hospital,from December 2021 to November 2022.Patients were randomized into two groups:the observation group(n=37)received combined therapy of statins and PCSK9 inhibitors,while the control group(n=43)received only statin therapy.Baseline characteristics and venous blood samples were collected to assess lipid profiles,inflammatory markers,and vascular endothelial function indicators.These parameters were re-evaluated after 6 months,and the occurrence of MACE during this period was documented.Results Six months post-treatment,the observation group demonstrated a significant reduction in total cholesterol,triglycerides,and low-density lipoprotein cholesterol compared to their baseline levels.The reduction was more pronounced than that in the control group(all P<0.05).Additionally,the observation group showed a marked decrease in high-sensitivity C-reactive protein and interleukin-6 levels compared to the control group(all P<0.05).Serum endothelin-1 levels in the observation group decreased,while nitric oxide levels increased significantly compared to the control group.During the 6-month follow-up,the observation group exhibited a marginally lower incidence of MACE than the control group(P<0.05).Conclusion Early intervention with PCSK9 inhibitors in NSTE-ACS patients effectively reduces blood lipid concentrations,alleviates inflammatory responses,enhances vascular endothelial function,and lowers the risk of major out-of-hospital adverse cardiovascular events.

关 键 词：PCSK9抑制剂 急性冠脉综合征 低密度脂蛋白胆固醇 高敏C反应蛋白 不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]