阿利西尤单抗在老年急性ST段抬高型心肌梗死患者PCI术后的应用效果

Application effects of Alirocumab combined with conventional therapy in elderly patients with acute ST segment elevation myocardial infarction after PCI

目的:观察阿利西尤单抗在老年急性ST段抬高型心肌梗死(STEMI)患者经皮冠脉介入治疗(PCI)术后的应用效果。方法:选取2020年1月至2022年1月124例老年STEMI患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各62例。两组均行PCI,对照组给予常规抗血小板和调脂治疗,观察组在对照组基础上给予阿利西尤单抗治疗,比较两组血脂[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]水平、炎性因子[肿瘤坏死因子-ɑ(TNF-α)、C反应蛋白(CRP)、白细胞介素6(IL-6)]水平、不良事件(再发心肌缺血、恶性心律失常、再发心肌梗死与再住院)发生率和不良反应发生率。结果:出院时,两组血清TC、LDL-C、TNF-α、CRP、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);出院后6个月,观察组再发心肌缺血、恶性心律失常、再发心肌梗死与再住院发生率均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿利西尤单抗联合常规治疗应用于老年STEMI PCI术后患者可降低血脂水平、炎性因子水平和不良事件发生率,效果优于单纯常规治疗。

Objective:To observe application effect of Alirocumab combined with conventional therapy in elderly patients with acute ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods:A prospective study was conducted on 124 elderly STEMI patients who underwent PCI from January 2020 to January 2022.They were divided into observation group and control group by using the random number table method,62 patients in each group.The control group received routine treatment,while the observation group received treatment with Alirocumab on the basis of that of the control group.The blood lipid levels[total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)],the inflammatory factor levels[tumor necrosis factorɑ(TNF-ɑ),C-reactive protein(CRP),interleukin-6(IL-6)],the incidence of adverse events(recurrent myocardial ischemia,malignant arrhythmia,recurrent myocardial infarction,and readmission),and incidence of adverse reactions were compared between the two groups.Results:At discharge,the levels of serum TC,LDL-C,TNF-α,CRP and IL-6 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Six months after discharge,the incidence of recurrent myocardial ischemia,malignant arrhythmia,recurrent myocardial infarction,and readmission in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Alirocumab combined with conventional therapy can reduce blood lipid levels,the inflammatory factor levels,and incidence of adverse events in the elderly patients after STEMI PCI.Moreover,it is superior to single conventional treatment.