PCSK9抑制剂对不同基线水平的甘油三酯降低效果不同

The triglyceride-lowering effects of PCSK9 inhibitor differ in patients with different baseline triglyceride levels

目的本研究旨在探讨不同甘油三酯(TG)基线水平下,使用前蛋白转化酶枯草杆菌蛋白酶9(PCSK9)抑制剂对甘油三酯的影响。方法选取2019年2月~2020年3月在南方医科大学南方医院、中山大学附属第一医院、佛山市南海区人民医院、玉林市第一人民医院及广东省人民医院等5家医院使用PCSK9抑制剂(Evolocumab,瑞百安)治疗的共59名患者,根据PCSK9抑制剂治疗前TG水平分为4组:正常组(TG<1.70 mmol/L,n=24),轻度升高组(1.70≤TG<2.29 mmol/L,n=11),中度升高组(2.30≤TG<5.63 mmol/L,n=13)及重度升高组(TG≥5.64 mmol/L,n=11),比较不同分组下PCSK9抑制剂对TG的影响。结果PCSK9抑制剂治疗后,不同TG分组间TG改变度不同,在TG正常组和轻度升高组中,TG降幅较小且TG前后变化无统计学意义,但在TG中度升高组及重度升高组,TG降幅较为明显且前后变化有统计学意义(P<0.005)。结论PCSK9抑制剂对不同基线水平的TG影响不同,基线较低时可能无明显作用,但在基线较高时降幅较大。

Objective To investigate the triglyceride(TG)-lowering effects of PCSK9 inhibitor in patients with in different baseline triglyceride levels.Methods Between February,2019 and March,2020,a total of 59 patients were treated with PCSK9 inhibitor(Evolocumab)in 5 hospitals,including Nanfang Hospital,Guangdong Provincial People's Hospital,First Affiliated Hospital of Sun Yat-sen University,Foshan Nanhai District People's Hospital and Yulin First People's Hospital.According to baseline triglyceride levels,the patients were divided into normal TG group(<1.70 mmol/L,n=24),mild hypertriglyceridemia group(1.70-2.29 mmol/L,n=11),moderate hypertriglyceridemia group(2.30-5.63 mmol/L,n=13),and severe hypertriglyceridemia group(≥5.64 mmol/L,n=11),and the changes in TG level after the treatment were compared among the 4 groups.Results In the groups with normal and mildly elevated baseline TG level,the patients did not show significant changes in TG levels after the treatment.In patients with moderately and severely elevated baseline TG levels,treatment with PCSK9 inhibitor significantly reduced their TG levels(P<0.005).Conclusion PCSK9 inhibitor has a significant TG-lowering effect in patients with moderate to severe hypertriglyceridemia but not in patients with only mildly elevated baseline TG level.