依洛尤单抗在冠心病降脂治疗中的疗效与安全性探讨

Efficacy and safety of Evolocumab in lipid-lowering therapy for coronary heart disease

目的探讨依洛尤单抗在冠心病患者降脂治疗中的疗效与安全性。方法入选2019年7月至2021年8月于山西省心血管病医院行冠状动脉造影后确诊冠心病的患者30例,所有患者均在他汀类药物治疗的基础上加用依洛尤单抗140 mg皮下注射[他汀类药物不耐受或用药前丙氨酸转移酶(ALT)升高的患者单用依洛尤单抗],观察给予依洛尤单抗治疗6个月内的血脂总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),三酰甘油(TG)、空腹血糖、ALT]及肾功能(肌酐)水平变化。结果应用依洛尤单抗治疗可以明显降低TC及LDL-C水平,但TG、HDL-C、ALT、肌酐及空腹血糖水平变化差异无统计学意义。结论对于存在他汀类药物不耐受或合并多支血管病变的冠心病患者,因LDL-C水平未达到700 mg/L(1.8 mmol/L),单用或加用依洛尤单抗治疗后可以显著降低LDL-C水平,而且依洛尤单抗对空腹血糖、ALT水平及肾功能水平差异无统计学意义。

Objective To investigate the efficacy and safety of Evolocumab in lipid-lowering therapy in patients with coronary heart disease.Methods Thirty patients,who were diagnosed with coronary heart disease after coronary angiography in Shanxi Provincial Cardiovascular Hospital between July 2019 and August 2020,were included in the study.All patients were treated with Evolocumab 140 mg subcutaneous injection in addition to statin therapy[Evolocumab was used alone in patients with statin intolerance or elevated alanine aminotrans-ferase(ALT)before medication].During 6 months of Evolocumab treatment,the changes in the levels of blood lipids[total cholesterol(CHO),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and triglyceride(TG)],fasting blood glucose,liver function[alanine aminotransferase(ALT)]and renal function[creatinine(Cr)]were determined.Results Evolocumab treatment could significantly reduce the levels of CHO and LDL-C,but there were no statistical difference in the changes of TG,HDL-C,ALT,creatinine and fast-ing blood glucose levels.Conclusion For patients with coronary heart disease who are intolerant to statins or complicated with multivessel disease but the LDL-C level does not reach 700 mg/L(1.8 mmol/L),the LDL-C level may be significantly reduced after using Evolocumab alone or additionally.Moreover,Evolocumab shows no statis-tical significance on the levels of fasting blood glucose,ALT and renal function.