摘要
目的观察急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后皮下注射依洛尤单抗的降脂效果及安全性。方法选择行PCI手术的ACS患者145例,随机分为观察组73例、对照组72例。对照组术后按照ACS围手术期用药指南给予常规剂量他汀类药物治疗,观察组在对照组基础上每次皮下注射依洛尤单抗140 mg,2周1次,两组均治疗1个月。记录两组治疗前后血脂相关指标,包括总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、脂蛋白(a)[Lp(a)]、载脂蛋白A1(ApoA1)、ApoB/ApoA1及LDL-C<1.8 mmol/L、LDL-C<1.4 mmol/L的比例,以及两组治疗后LDL-C较基线下降>50%且<1.4 mmol/L的比例。记录两组用药安全性相关指标,包括治疗前后的空腹血糖(FPG)、丙氨酸氨基转移酶(ALT)、肌酐(Cre),以及药物不良反应及主要不良心血管事件(MACE)发生情况。结果与治疗前比较,两组治疗后LDL-C<1.8 mmol/L及<1.4 mmol/L的比例均升高,且观察组较对照组升高更明显(P均<0.05)。观察组治疗后LDL-C较基线下降>50%且<1.4 mmol/L的比例高于对照组(P<0.05)。与治疗前比较,两组治疗后TC、TG、LDL-C、Lp(a)、ApoB、ApoB/ApoA1均降低,ApoA1均升高,且观察组较对照组治疗后变化更明显(P均<0.05)。两组治疗前后FPG、ALT及Cre比较差异均无统计学意义(P均>0.05)。观察组和对照组均发生肌痛1例,分别发生MACE 0、1例,两组比较P均>0.05。结论ACS患者PCI术后皮下注射依洛尤单抗有助于降低血脂水平,且安全性较高。
Objective To investigate the efficacy and safety of evolocumab to reduce lipid levels in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods Totally 145 ACS patients who underwent PCI were randomly divided into the observation group(73 cases)and the control group(72 cases).Pa⁃tients in the control group received conventional drug treatment according to the perioperative medication guidelines for ACS,while patients in the observation group received subcutaneous injection of evolocumab 140 mg per dose,once every two weeks,on the basis of the control group's treatment.Both groups were treated for one month.Changes in lipid-related indicators before and after treatment,including total cholesterol(TC),triglycerides(TG),high-density lipoprotein choles⁃terol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(ApoB),lipoprotein(a)[Lp(a)],apoli⁃poprotein A1(ApoA1),ApoB/ApoA1 ratio,and the proportion of LDL-C<1.8 mmol/L and LDL-C<1.4 mmol/L,were recorded.Additionally,the proportion of patients whose LDL-C decreased by>50%and was<1.4 mmol/L compared to baseline was recorded.Safety-related indicators,including fasting plasma glucose(FPG),alanine aminotransferase(ALT),creatinine(Cre)before and after treatment,adverse reactions,and major adverse cardiovascular events(MACE)were also recorded.Results The proportions of LDL-C<1.8 mmol/L and<1.4 mmol/L increased in both groups after treatment in comparison with those before treatment,with more significant increase in the observation group(both P<0.05).The proportion of patients in the observation group whose LDL-C decreased by>50%and was<1.4 mmol/L com⁃pared to baseline was higher than that in the control group(P<0.05).TC,TG,LDL-C,Lp(a),ApoB,and ApoB/ApoA1 decreased,and ApoA1 increased in both groups after treatment in comparison with those before treatment,with more sig⁃nificant changes in the observation group(all P<0.05).No significant differences were found in FPG,ALT,or Cre be⁃tween the two groups before a
作者
孙玉宇
李丹妮
夏林莺
金萍
SUN Yuyu;LI Danni;XIA Linying;JIN Ping(Department of Cardiology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
出处
《山东医药》
CAS
2024年第23期31-35,共5页
Shandong Medical Journal
基金
陕西省自然科学基础研究计划青年项目(2022JQ-787)。
