摘要
目的探讨前蛋白转换酶枯草溶菌素9(PCSK9)抑制剂—依洛尤单抗注射液对急性心肌梗死(AMI)患者血脂、肝肾功能、心脏结构和心功能、再发心血管事件的影响。方法回顾性选取2020年1月—2023年1月于武汉大学人民医院心内科就诊的AMI患者106例为研究对象,根据随机数字表法将患者分为对照组(n=53)与观察组(n=53)。对照组患者采用他汀类药物进行降脂治疗,观察组患者在对照组治疗基础上给予依洛尤单抗注射液,2组患者均连续用药1个月并进行复查。比较2组患者治疗前后血脂水平、肝肾功能、超声心动图检查指标及心血管不良事件发生率。结果治疗1个月后,2组患者TC、LDL-C水平均低于治疗前,且观察组均低于对照组(t/P=3.656/<0.001、4.342/<0.001),2组TG、HDL-C水平比较,差异无统计学意义(P>0.05);治疗1个月后,2组ALT、AST水平均低于治疗前(t/P=3.877/<0.001、5.082/<0.001、10.172/<0.001、13.644/<0.001),但治疗后2组ALT、AST水平比较,差异均无统计学意义(P>0.05);治疗前后2组肾功能指标比较差异均无统计学意义(P>0.05);治疗1个月后,观察组左心室射血分数(LVEF)高于治疗前(t/P=3.542/0.001),对照组、观察组室间隔厚度(IVSD)均小于治疗前(t/P=3.005/0.004、3.042/0.004);治疗1年后,观察组心血管不良事件发生率为3.8%,低于对照组的20.8%(χ^(2)=7.102,P=0.008)。结论依洛尤单抗注射液可大幅降低AMI患者血脂和心血管不良事件再发率,改善心功能,同时对肝肾功能无显著影响。
Objective To investigate the effects of proprotein convertase subtilisin/kexin type-9(PCSK9)inhibitors on lipid profiles,liver and renal function,and recurrent cardiovascular events in patients after myocardial infarction.Methods A total of 106 patients with acute myocardial infarction who were treated at the Renmin Hospital of Wuhan University from 2020 to 2023 were retrospectively collected for this study.Patients were divided into a control group(n=53)and an observation group(n=53)according to the treatment plan.Patients in the control group received statin therapy for lipid-lowering treatment,while patients in the observation group received PCSK9 inhibitors in addition to statin therapy.Both groups of patients received continuous medication for one month and underwent follow-up examinations.The lipid levels,liver and renal function,and echocardiographic parameters before and after treatment were compared between the two groups.Results After treatment,the levels of TCh,LDL-C were lower than before treatment in two groups,and the TCh and LDL-C levels in the observation group were lower than those in the control group(t/P=3.656/<0.001,4.342/<0.001),and the levels of TG was lower than before treatment in the observation group.However,there was no significant difference between the comparison of HDL-C levels in the 2 groups after treatment(P>0.05).After treatment,the levels of ALT and AST in 2 groups were lower than before treatment(t/P=3.877/<0.001,5.082/<0.001,10.172/<0.001,13.644/<0.001),but there was no difference in the ALT levels between 2 groups after treatment(P>0.05).There was no difference in the renal function index in 2 groups after treatment and in both 2 groups before and after treatment(P>0.05).After treatment,the level of LVEF was higher in the observation group(t/P=3.542/0.001),and IVSD in the 2 groups were lower than before treatment(t/P=3.005/0.004,3.042/0.004).The incidence of cardiovascular adverse events in the observation group was 3.8%,lower than 20.8%in the control group(χ^(2)/P=7.102/0.0
作者
赵泳捷
林泽阳
冯高科
宋涛
黄燕
Zhao Yongjie;Lin Zeyang;Feng Gaoke;Song Tao;Huang Yan(Department of Cardiology,Renmin Hospital of Wuhan University,The First Clinical College of Wuhan University,Hubei Province,Wuhan 430060,China)
出处
《疑难病杂志》
CAS
2024年第12期1413-1418,共6页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金资助项目(82100331)
湖北省自然科学基金(2023AFB797)
武汉市知识创新专项项目(2022020801020484)。
关键词
急性心肌梗死
依洛尤单抗注射液
血脂
肝肾功能
再发心血管不良事件
疗效
Acute myocardial infarction
Evolocumab injection
Lipid levels
Liver function and renal function
Recurrent cardiovascular adverse event
Clinical efficacy
