依洛尤单抗联合阿托伐他汀对急性冠状动脉综合征患者经皮冠状动脉介入术远期预后的影响分析

Effects of evolocumab combined with atorvastatin on long-term prognosis in patients with acute coronary syndrome after percutaneous coronary intervention

目的 分析短期注射依洛尤单抗联合阿托伐他汀对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术远期预后的影响。方法 将接受PCI术治疗的ACS患者,随机分为试验组和对照组。对照组给予阿托伐他汀20 mg,每天1次,口服;试验组在对照组的基础上给予依洛尤单抗140 mg,每2周注射1次。2组均治疗6个月。比较2组患者心肌损伤标志物、血脂变化、血管内皮功能和终点事件。结果 试验组和对照组各43例。治疗后,试验组和对照组的肌酸激酶(CK-MB)分别为(35.23±8.22)和(46.58±7.41) U·L^(-1),心肌肌钙蛋白Ⅰ(cTnⅠ)分别为(2.04±0.18)和(3.25±0.73) ng·mL^(-1),乳酸脱氢酶(LDH)水平分别为(184.79±19.68)和(249.30±22.38) U-1,总胆固醇(TC)水平分别为(3.28±0.47)和(3.93±0.52) mmol·L^(-1),三酰甘油(TG)水平分别为(1.43±0.23)和(1.58±0.21) mmol·L^(-1),低密度脂蛋白胆固醇(LDL-C)水平分别为(1.62±0.38)和(1.84±0.42) mmol·L^(-1),高密度脂蛋白胆固醇(HDL-C)水平分别为(1.36±0.25)和(1.24±0.22) mmol·L^(-1),内皮素-1(ET-1)水平分别为(40.53±5.29)和(59.62±7.11) ng·L^(-1),一氧化氮(NO)水平分别为(48.32±4.29)和(43.28±4.05)μmol·L^(-1),差异均有统计学意义(均P<0.05)。试验组ACS患者药物不良反应总发生率为16.28%,对照组为18.60%,差异无统计学意义(P>0.05)。试验组终点事件总发生率为13.95%,对照组为34.88%,差异有统计学意义(P<0.05)。结论 短期注射依洛尤单抗联合阿托伐他汀具备调节ACS患者PCI术后血脂的效果,同时具有改善心肌和血管内皮功能的作用,安全性高。

Objective To analyze the effects of short-term injection of evolocumab combined with atorvastatin on long-term prognosis in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods Patients with ACS underwen PCI were randomly divided into treatment group and control group.Control group was given oral atorvastatin 20 mg,once a day;while treatment group was given evolocumab 140 mg,2 week a time.Both groups were treated for 6 months.The myocardial injury markers,changes of blood lipid,vascular endothelial function and endpoint events were compared between the two groups.Results There were 43 cases in treatment group and 43 cases in control group.After treatment,levels of creatine kinase-MB(CK-MB)in treatment group and control group were(35.23±8.22)and(46.58±7.41)U·L^(-1);levels of cardiac troponinⅠ(c TnⅠ)were(2.04±0.18)and(3.25±0.73)ng·mL^(-1);levels of lactate dehydrogenase(LDH)were(184.79±19.68)and(249.30±22.38)U·L^(-1);levels of total cholesterol(TC)were(3.28±0.47)and(3.93±0.52)mmol·L^(-1);levels of triglyceride(TG)were(1.43±0.23)and(1.58±0.21)mmol·L^(-1);levels of low-density lipoprotein cholesterol(LDL-C)were(1.62±0.38)and(1.84±0.42)mmol·L^(-1);levels of high-density lipoprotein cholesterol(HDL-C)were(1.36±0.25)and(1.24±0.22)mmol·L^(-1),levels of endothelin 1(ET-1)were(40.53±5.29)and(59.62±7.11)ng·L^(-1);levels of nitric oxide(NO)were(48.32±4.29)and(43.28±4.05)μmol·L^(-1);the differences were statistically significant(all P<0.05).There was no significant difference in total incidence of adverse drug reactions between treatment group and control group(16.28%vs 18.60%,P>0.05).The differences in total incidence of endpoint events between treatment group and control group were statistically significant(13.95%vs34.88%,P<0.05).Conclusion Short-term injection of evolocumab combined with atorvastatin can regulate blood lipid,improve myocardial and vascular endothelial function in ACS patients after PCI,with high safety.