临床药师参与1例超高危ASCVD合并肝肾功能异常患者的调脂治疗实践

Practice of Clinical Pharmacist Participating in Lipid-lowering Therapy for a Case of Ultra-high Risk ASCVD Complicated with Liver and Kidney Dysfunction

血脂异常特别是低密度脂蛋白胆固醇(LDL-C)水平升高是超高危动脉粥样硬化性心血管疾病(ASCVD)患者的重要危险因素,也是超高危ASCVD调脂治疗的首要干预靶点。临床药师参与1例2年内发生2次严重ASCVD事件的超高危ASCVD合并肝肾功能异常患者的调脂治疗,参考指南、文献及药品说明书,并结合临床实际进行分析,根据患者LDL-C水平提供调脂治疗方案,给予小剂量阿托伐他汀联合依洛尤单抗的二联调脂方案治疗2个月,复查LDL-C由2.6 mmol·L^(-1)降至1.0 mol·L^(-1),4个月后降至0.9 mol·L^(-1)。临床药师参与治疗,更好地保障患者用药的安全性、有效性和经济性。

Dyslipidemia,especially the elevated level of low-density lipoprotein cholesterol(LDL-C),is an important risk factor for patients with ultra-high risk atherosclerotic cardiovascular disease(ASCVD),and it is also the primary intervention target of lipid-lowering therapy for ultra-high risk ASCVD.Clinical pharmacist participated in the lipid-lowering treatment of a patient with ultra-high risk ASCVD complicated with abnormal liver and kidney function who had two serious ASCVD events within two years.Clinical pharmacist referred to the guidelines,literature and drug instructions,analyzed in combination with clinical practice,provided lipid-lowering treatment scheme according to the patient’s LDL-C level,and suggested the treatment with low-dose atorvastatin combined with iloyumab for two months.After treatment,the patient’s LDL-C level decreased from 2.6 mmol·L^(-1) to 1.0 mmol·L^(-1),and further decreased to 0.9 mmol·L^(-1) after 4 months.The participation of clinical pharmacists in the treatment can better ensure the safety,effectiveness and economy of patients’medication.