瑞舒伐他汀联合依洛尤单抗或依折麦布对急性冠脉综合征患者的疗效

Effect of Rosuvastatin Combined with Evolocumab or Ezetimibe on Intensive Lipid-lowering in Patients with Acute Coronary Syndrome

目的对比观察瑞舒伐他汀基础上联合依洛尤单抗或依折麦布对急性冠脉综合征患者强化降脂效果及安全性。方法选取在河南省胸科医院就诊确诊为急性冠脉综合征并行介入治疗患者,经严格控制饮食并应用瑞舒伐他汀10 mg治疗8周后低密度脂蛋白胆固醇(LDL-C)水平仍不达标(LDL-C>1.8 mmol·L^(-1))99例,随机分为两组:瑞舒伐他汀(每晚10 mg)+依洛尤单抗(每2周140 mg)组(49例)、瑞舒伐他汀(每晚10 mg)+依折麦布(每日10 mg)组(50例),持续应用12周,观察基线及4、8、12周时LDL-C水平变化。结果重复测量方差分析显示,总胆固醇、LDL-C、甘油三酯组间效应、时间效应及交互效应有统计学意义(P<0.05),治疗前两组总胆固醇、LDL-C、甘油三酯水平比较,差异无统计学意义(P>0.05);治疗后两组患者总胆固醇、LDL-C、甘油三酯水平低于治疗前,差异有统计学意义(P<0.05);治疗后各组总胆固醇、LDL-C、甘油三酯水平差异无统计学意义(P>0.05)。两组不良事件差异无统计学意义(P>0.05)。结论联合依洛尤单抗或依折麦布均可进一步降低LDL-C水平,而联合依洛尤单抗组降低了LDL-C水平并增加了达到推荐控制LDL-C水平的可能,具有较好的降脂效果及安全性。

Objective To compare and observe the lipid-lowering effect and safety of rosuvastatin combined with evolocumab or ezetimibe in patients with acute coronary syndrome with coronary heart disease.Methods A total of 99 patients diagnosed with acute coronary syndrome of coronary heart disease in Henan Provincial Chest Hospital were selected for concurrent interventional treatment,and after strict diet control and treatment with rosuvastatin 10 mg for 8 weeks,the low-density lipoprotein cholesterol(LDL-C)level still did not meet the standard(LDL-C>1.8 mmol·L^(-1)),and were randomly divided into two groups:rosuvastatin(10 mg per night)+elocumumab(140 mg every two weeks)group(49 cases)and rosuvastatin(10 mg per night)+ezetimibe(10 mg daily)group(50 cases)for 12 weeks.Changes in LDL-C levels at baseline and at 4,8 and 12 weeks were observed.Results Repeated measurement analysis of variance showed that the total cholesterol,LDL-C and triglycerides were compared in group effects,time effects,and interaction effects,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of total cholesterol,LDL-C and triglycerides between the two groups before treatment(P>0.05).After treatment,the levels of total cholesterol,LDL-C and triglycerides in the two groups of patients were lower than before treatment(P<0.05).After treatment,there was no statistically significant difference in the levels of total cholesterol,LDL-C and triglycerides among the groups(P>0.05).There was no statistically significant difference in adverse events between the two groups(P>0.05).Conclusion Combined with evolocumab or ezetimibe can further reduce LDL-C levels,while the combination of elocumumab reduces LDL-C levels and increases the possibility of achieving the recommended control LDL-C level,which has better lipid-lowering effect and safety.