阿利西尤单抗对STEMI患者PCI后冠状动脉微循环、脂代谢及预后的影响  

Effect of alirocumab on coronary microcirculation,lipid metabolism and prognosis in patients with STEMI after PCI

作　　者：魏国士 徐婷婷 张社芳 Wei Guoshi;Xu Tingting;Zhang Shefang(Department of Pharmacy,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China;Department of Ultrasound,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院药学部,洛阳471000 [2]郑州大学附属洛阳中心医院超声科,洛阳471000

出　　处：《中国实用医刊》2025年第3期78-81,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨阿利西尤单抗对ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后冠状动脉微循环、脂代谢及预后的影响。方法队列研究。抽取郑州大学附属洛阳中心医院2022年6月至2023年8月收治的92例STEMI患者,均接受PCI治疗,按随机数字表法将患者分为对照组(46例)和观察组(46例)。对照组采用常规治疗,观察组采用常规治疗+阿利西尤单抗治疗,两组均治疗6个月。比较两组冠状动脉微循环[心肌梗死溶栓治疗(TIMI)血流分级]情况、脂代谢指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、二尖瓣口舒张早期与晚期峰值血流速度比值(E/A)、血清肌钙蛋白I(cTnI)]和预后情况[主要不良心血管事件发生率(MACE)]。结果术后6个月,观察组TIMI分级优于对照组(P<0.05);术后6个月,观察组TC、TG、cTnI、LVESD、LDL-C水平均低于对照组,LVEF、E/A水平高于对照组(P<0.05);术后6个月,观察组MACE(23.91%,11/46)低于对照组(6.52%,3/46),P<0.05。结论阿利西尤单抗可有效调节STEMI患者PCI后脂代谢,改善冠状动脉微循环,提高心功能,改善患者预后,降低MACE发生风险。Objective To investigate the effect of alirocumab on coronary microcirculation,lipid metabolism and prognosis in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).MethodsA total of 92 STEMI patients admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from June 2022 to August 2023 were selected for the cohort study,and they were all treated by PCI.They were divided into the control group(46 cases)and the observation group(46 cases)according to random number table method.The control group was treated by conventional therapy,and the observation group was treated by conventional therapy+alirocumab,both groups were treated for 6 months.The coronary microcirculation assessed by thrombolysis in myocardial infarction(TIMI)grading,lipid metabolism indicators,including total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C),cardiac function assessed by left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),ratio of early and late mitral diastolic peak blood flow velocity(E/A)and serum troponin I(cTnI),and prognosis assessed by incidence of major adverse cardiovascular events(MACE)were compared between the two groups.ResultsAt 6 months after operation,the TIMI grade of the observation group was better than that of the control group(P<0.05).At 6 months after operation,the levels of TC,TG,cTnI,LVESD and LDL-C in the observation group were lower than those in the control group,and the levels of LVEF and E/A were higher than those in the control group(P<0.05).At 6 months after operation,the incidence of MACE in the observation group(23.91%,11/46)was lower than that in the control group(6.52%,3/46),P<0.05.ConclusionsAlirocumab can effectively regulate lipid metabolism,improve coronary microcirculation,enhance cardiac function,improve prognosis and reduce the risk of MACE in STEMI patients after PCI.

关 键 词：ST段抬高心肌梗死 阿利西尤单抗 经皮冠状动脉介入治疗术 冠状动脉微循环 脂代谢 预后 

分 类 号：R541.4[医药卫生—心血管疾病]