依折麦布和依洛尤单抗联合治疗高胆固醇血症伴冠心病患者的临床研究  

Clinical study of ezetimibe and evolocumab combination trerapy in patients with hypercholesterolemia and coronary heart disease

作　　者：信鸿巍 李景瑞[1] 丁园园 王春莹[1] 孙艳霞 张百会 吴晓杰[1] XIN Hongwei;LI Jingrui;DING Yuanyuan;WANG Chunying;SUN Yanxia;ZHANG Baihui;WU Xiaojie(Department of Cardiovascular Medicine,Second Affiliated Hospital of Qiqihar Medical College,Qiqihar 161000)

机构地区：[1]齐齐哈尔医学院附属第二医院心血管内科,齐齐哈尔161000

出　　处：《湖南师范大学学报(医学版)》2024年第5期81-85,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：齐齐哈尔市科技计划联合引导项目“心房颤动患者经皮冠状动脉介入后的抗血栓潜在生物标志物和治疗靶点的综合分析”(LSFGG-2023078);2022年度黑龙江省省属高等学校基本科研业务费科研项目(2022-KYYWF-0791)

摘　　要：目的:观察依洛尤单抗与依折麦布联合对冠心病(coronary heart disease,CHD)合并高胆固醇血症患者的治疗疗效以及对血脂水平、心功能和血清同型半胱氨酸(homocysteine,HCY)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、氧化低密度脂蛋白(oxidized low-density lipoprotein,ox-LDL)水平的影响。方法:选取2023年3月—2024年3月于本院进行治疗的CHD合并高胆固醇血症130 例患者,随机分成对照组与实验组,各65例。两组均给予常规治疗,对照组在常规治疗的基础上给予依折麦布治疗,实验组在常规治疗的基础上给予依洛尤单抗联合依折麦布治疗,观察治疗疗效以及对患者血脂水平、心功能和血清HCY、ox-LDL、hs-CRP水平的影响,并评价其治疗安全性。结果:治疗后,实验组冠心病治疗疗效与降脂疗效均显著高于对照组。治疗后两组患者血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平下降,高密度脂蛋白胆固醇(HDL-C)水平升高,实验组TC、TG、LDL-C水平相比于对照组更低,HDL-C水平更高;治疗后两组患者左室舒张末期内径(LVEDd)与左室收缩末期内径(LVESd)均有所下降,左心室射血分数(LVEF)均有所提高,相对实验组LVEF比于对照组更高,LVEDd与LVESd更低。治疗后,两组HCY、ox-LDL、hs-CRP水平均有显著下降,实验组明显低于对照组。治疗期间发现两组不良反应发生率无显著差异。结论:依洛尤单抗与依折麦布联合治疗CHD合并高胆固醇血症伴患者相较于单一的依折麦布治疗疗效更好,能有效改善患者血脂水平与心功能,并降低血清HCY、ox-LDL、hs-CRP水平,且治疗安全性较高。Objective To observe the therapeutic effect of combined treatment with ezetimibe and evolocumab on patients with hypercholesterolemia and coronary heart disease(CHD),and the impact on blood lipid levels,cardiac function,and serum homocysteine(HCY),oxidized low-density lipoprotein(ox-LDL)and high-sensitivity C-reactive protein(hs-CRP)levels.Methods A total of 130 patients with hypercholesterolemia and CHD who were treated in the hospital from April 2023 to April 2024 were selected,and randomly assigned to the control group and the experimental group,with 65 cases in each group.Both groups received conventional treatment,with the control group receiving ezetimibe in addition to conventional treatment,and the experimental group receiving a combination of erlotinib and ezetimibe in addition to conventional treatment.Therapeutic effects,blood lipid levels,cardiac function,and serum HCY,ox-LDL and hs-CRP levels were observed,and evaluate its therapeutic safety.Results After treatment,therapeutic effect on CHD and lipid-lowering effect in the experimental group were significantly better compared to the control group.After treatment,the levels of total cholesterol(TC),triacylglycerol(TG)and low-density lipoprotein cholesterol(LDL-C)in the two groups decreased,and the levels of high-density lipoprotein cholesterol(HDL-C)increased.Meanwhile,the levels of TC,TG and LDL-C were lower,and the level of HDL-C was higher in the experimental group.Left ventricular ejection fraction(LVEF)in the two groups was significantly increased,and left ventricular end diastolic diam-eter(LVEDd)and left ventricular end systolic diameter(LVESd)were significantly reduced.LVEF in the experimental group was significantly higher.LVEDd and LVESd in the experimental group were significantly smaller.After treatment,the levels of HCY,ox-LDL and hs-CRP in the two groups were significantly reduced,and the levels were significantly lower in the experimental group.During the treatment period,no significant difference was found in the incidence of adverse r

关 键 词：冠心病 高胆固醇血症 依洛尤单抗 血脂水平 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]