PCSK9抑制剂在冠状动脉粥样硬化性心脏病治疗中的研究进展

Research progress of PCSK9 inhibitors in coronary atherosclerotic heart disease

动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)是目前临床上较为常见的心血管疾病之一,其发病原因主要与动脉粥样硬化有关,故降低胆固醇、低密度脂蛋白,延缓动脉粥样硬化进展是ASCVD防治的基础,临床首选药物为他汀类药物。但长期临床实践发现,仍有部分ASCVD患者降脂效果不理想,或无法耐受他汀类最大剂量,故需寻求其他治疗方法预防心血管疾病。人前蛋白转化酶枯草溶菌素9(PCSK9)抑制剂近年来被证实具有良好的降血脂作用,对低密度脂蛋白的调节效果尤为明显,临床Ⅱ期和Ⅲ期试验均已明确其良好的安全性和耐受性。现对PCSK9基因与心血管疾病的关系、PCSK9抑制剂的临床研究进展和PCSK9的不良反应等进行综述。

Atherosclerotic cardiovascular disease(ASCVD)is one of the most common cardiovascular diseases in the clinic.Its pathogenesis is mainly related to atherosclerosis.Therefore,lowering cholesterol and low-density lipoprotein and delaying the progression of atherosclerosis are basical for the prevention and treatment of ASCVD.Statins are the first choice for clinical treatment.But long-term clinical practice found that some ASCVD patients have unsatisfactory lipid-lowering effects,or cannot tolerate the maximum dose of statins,so it is necessary to seek other treatment methods to prevent cardiovascular diseases.In recent years,it has been proved that PCSK9 inhibitor has a good hypolipidemic effect,especially on low-density lipoprotein.The clinical phaseⅡand phaseⅢtrials have confirmed its good safety and tolerance.This article reviews the relationship between PCSK9 gene and cardiovascular disease,the basic research and clinical application of PCSK9 inhibitors,and the adverse reactions of PCSK9.