依洛尤单抗注射液对高低密度脂蛋白胆固醇血症患者脂蛋白a和高敏C反应蛋白的影响研究

Influence of Evolocumab injection on lipoprotein(a)and high-sensitivity c-reactive protein in patients with high low-density lipoprotein cholesterol

目的评估依洛尤单抗注射液在高低密度脂蛋白胆固醇血症患者用药前后血清脂蛋白a和高敏C反应蛋白的变化。方法收集2019年7月至2019年12月北京阜外医院心内科应用依洛尤单抗注射液的高低密度脂蛋白胆固醇血症(LDL-C)患者,分为家族性高胆固醇血症组(FH)和非家族性高胆固醇血症组(NFH),比较两组间基线人口学特征、传统心血管危险因素、口服降脂药应用、以及应用依洛尤单抗前后血清LDL-C、脂蛋白a[Lp(a)]、高敏C反应蛋白(hsCRP)水平的变化。结果(1)总计49例使用依洛尤单抗注射液的高LDL-C患者,女性12例(24.5%),平均年龄(54.1±11.8)岁,其中FH组15例,NFH组34例。FH组更加年轻,NFH组心血管危险因素合并症发生情况则更高。基线LDL-C水平FH组显著高于NFH组,(3.86±1.65)mmol/L对(3.19±0.60)mmol/L,P=0.041。(2)依洛尤单抗注射液对LDL-C水平在FH组和NFH组较用药前分别降低54.9%和49.5%,均有显著改善。(3)FH组患者在用药前后,其Lp(a)和hsCRP水平未见显著变化;而在NFH组患者,Lp(a)和hsCRP水平在用药后较用药前均有显著下降,用药前后Lp(a)分别为(433±389)mg/L对(216±270)mg/L,P=0.049,hsCRP分别为(2.68±2.57)mg/L对(1.62±1.52)mg/L,P=0.037。结论依洛尤单抗注射液可显著降低高危患者LDL-C水平,其对Lp(a)和hsCRP的影响在NFH患者中具有更高的敏感性。

Objective To evaluate the changes of serum lipoprotein(a)[Lp(a)]and high-sensitivity C-reactive protein(hsCRP)by Evolocumab injection in patients with high low-density lipoprotein cholesterol(LDL-C).Methods Patients with high LDL-C who received Evolocumab were collected and divided into familial hypercholesterolemia(FH)group and non-familial hypercholesterolemia(NFH)group.Compare the baseline demographics,cardiovascular risk factors,use of oral lipid-lowering drugs,and changes of serum LDL-C and Lp(a),hsCRP before and after the use of Evolocomab between the two groups.Results:(1)There were total 49 patients enrolled,12 were female(24.5%),15 in FH group and 34 in the other.Compared with that in NFH group,the patients in FH group were younger and less cardiovascular risk factors.Baseline LDL-C in FH and NFH were(3.86±1.65)mmol/L and(3.19±0.60)mmol/L respectively,P=0.041.(2)Compared with the baseline,the LDL-C in FH and NFH groups reduced 54.9%and 49.5%significantly by Evolocumab.(3)No significant changing of Lp(a)or hsCRP in FH group,while both of them decreased significantly in NFH group with Evolocumab administration,which Lp(a)was(433±389)mg/L vs(216±270)mg/L,P=0.049,and hsCRP was(2.68±2.57)mg/L vs(1.62±1.52)mg/L,P=0.037.Conclusion Evolocumab injection can significantly reduce LDL-C in high-risk patients,and the effects on Lp(a)and hsCRP are more sensitive in NFH patients.