双联抗血小板药物联合不同剂量阿利西尤对ACS合并慢性肾病患者非冠状动脉介入治疗的疗效  

Efficacy of Dual Antiplatelet Drugs Combined with Different Doses of Ali⁃rocumab in Patients with Non Coronary Intervention Treatment for ACS Com⁃plicated with Chronic Kidney Disease

作　　者：方婷婷 曹军 余太辉 FANG Tingting;CAO Jun;YU Taihui(Department of Cardiovascular Medicine,Hubei Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430021,China)

机构地区：[1]湖北省中西医结合医院心血管内科,武汉430021

出　　处：《岭南心血管病杂志》2025年第1期13-20,共8页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨双联抗血小板药物联合不同剂量阿利西尤对急性冠状动脉综合征(acute coronary syndrome,ACS)合并慢性肾病(chronic kidney disease,CKD)患者非冠状动脉介入治疗(percutaneous coronary intervention,PCI)的疗效。方法选取2021年8月至2023年4月于湖北省中西医结合医院就诊的120例ACS合并CKD非PCI治疗的患者为研究对象,根据阿利西尤剂量随机分为A组(55 mg,n=40)、B组(65 mg,n=40)和C组(75 mg,n=40)。比较3组患者的临床资料、治疗后血脂和肝及肾功能情况、治疗后的临床疗效、治疗后不良反应、不良事件的发生情况。Kaplan-Meier法绘制生存曲线直观描述组间总有效率差异,并应用Log Rank进行差异显著性检验。结果治疗6个月后C组患者的血清丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBil)浓度显著高于A组、B组;血清肌酐(serum creatinine,Scr)、血尿素氮(blood urine nitrogen,BUN)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)显著低于A组和B组,差异均有统计学意义(P<0.05)。3组患者接受治疗1个月后,A组患者的总有效率为80.00%;B组患者的总有效率为85.00%;C组患者的总有效率为97.50%,C组患者的总有效率显著高于A组和B组,差异有统计学意义(P<0.05)。生存曲线结果显示,3组患者治疗6个月后临床疗效差异显著(χ2=0.713、0.628、0.513,P<0.05)。结论阿利西尤75 mg剂量联合双联抗血小板药物在对ACS合并CKD患者的非PCI治疗中有效性最优,双联抗血小板药物联合75 mg阿利西尤可有效改善ACS合并CKD患者的血脂和肝及肾功能,且安全性较好。Objectives To investigate the effects of dual antiplatelet agents combined with different doses of alirocumab in patients with acute coronary syndrome(ACS)combined with chronic kidney disease(CKD)undergoing non-coronary intervention(PCI)treatment.Methods Totally 120 patients with ACS complicated with CKD who underwent non PCI treatment at Hubei Province Integrated Traditional Chinese and Western Medicine Hospital from August 2021 to April 2023 were selected as the study subjects.They were randomly divided into A group(55 mg,n=40),B group(65 mg,n=40),and C group(75 mg,n=40)based on the dose of alirocumab.The clinical data,blood lipid concentration after treatment,liver and kidney function,clinical efficacy after treatment,and incidence of adverse reactions and events among the three groups were compared.The Kaplan Meier method was used to draw survival curves to visually describe the differences in total effective rates among the three groups,and Log Rank was used for significance testing of the differences.Results Alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)in C group were significantly higher than those in A group and B group at 6 months after treatment(P<0.05);while serum creatinine(Scr),blood urine nitrogen(BUN),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were significantly lower than those in A group and B group(P<0.05).After 1 month of treatment,the total effective rate of A group was 80.00%,the total effective rate of B group was 85.00%,the total effective rate of C group was 97.50%.The total effective rate of C group was significantly higher than those of A group and B group(P<0.05).The survival curve showed that there were significant differences in clinical efficacy among the three groups at 6 months after treatment(χ^(2)=0.713,0.628,0.513,P<0.05).Conclusions Dosage of 75 mg alirocumb combining dual antiploctelet drugs contributes to the most effective treatment in patients with

关 键 词：冠状动脉疾病 慢性肾病 阿利西尤 不同剂量 非冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病] R692[医药卫生—内科学]