阿利西尤单抗联用海博麦布对急性ST段抬高型心肌梗死的疗效

Clinical efficacy of alirocumab combined with ybutimibe in acute ST⁃elevation myocardial infarction

目的探究阿利西尤单抗联用海博麦布在急性ST段抬高型心肌梗死(STEMI)中的临床疗效。方法将112例STEMI患者随机分为对照组和研究组,各56例。所有患者入院后行PCI治疗。对照组术后口服海博麦布治疗,研究组联合阿利西尤单抗治疗。维持治疗6个月后,比较两组的低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯、总胆固醇、左心室射血分数(LVEF)、二尖瓣口舒张早期与晚期峰值血流速度比(E/A)、左心室收缩末期内径(LVESD)、脑利钠肽前体(NT-proBNP)、心肌肌钙蛋白(cTnI)、脂蛋白相关磷脂酶A2(Lp-PLA2)、基质金属蛋白酶-9(MMP-9)、白细胞介素-6(IL-6)、血流灌注分级(TIMI)、药物毒性及术后心血管不良事件。结果治疗后,两组LDL-C、甘油三酯、总胆固醇较治疗前均降低,研究组低于对照组(P<0.05)。两组治疗前后HDL-C比较,差异无统计学意义(P>0.05)。治疗后,两组LVEF、E/A较治疗前均升高,研究组高于对照组(P<0.05);两组LVESD、NT-proBNP、c TnI、Lp-PLA2、MMP-9、IL-6较治疗前均降低,研究组低于对照组(P<0.05)。术后6个月,研究组TIMIⅢ级占比高于对照组(P<0.05)。药物不良反应及术后心血管不良事件发生率比较,差异无统计学意义(P>0.05)。结论阿利西尤单抗联用海博麦布应用于STEMI PCI术后的治疗中,更有助于降低患者的血脂水平,促进血流灌注,改善心肌功能,安全性良好。

Objective To explore the clinical efficacy of alirocumab combined with ybutimibe in acute ST segment elevation myocardial infarction(STEMI).Methods A total of 112 cases of STEMI patients were randomly divided into control group and study group,with 56 cases in each.All patients underwent PCI treatment after admis⁃sion.The control group received oral administration of atorvastatin after the surgery,while the study group received combined treatment of atorvastatin with alirocumab.After 6 months of maintenance treatment,the low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides,total cholesterol,left ventricular ejection fraction(LVEF),early and late diastolic peak flow velocity ratio(E/A)of the mitral valve orifice,left ventricular end-systolic diameter(LVESD),N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),lipoprotein-associated phospholipase A2(Lp-PLA2),matrix metalloproteinase-9(MMP-9),interleukin-6(IL-6),thrombolysis in myocardial infarction(TIMI)flow grade,drug toxicity,and postopera⁃tive cardiovascular adverse events were compared between the two groups.Results After treatment,the level of LDL-C,triglycerides,and total cholesterol in both groups decreased,and more significant results were found inthe study group(P<0.05).There was no significant difference in HDL-C between the two groups before and after treatment(P>0.05).After treatment,LVEF and E/A in both groups increased,with more significantresults in the study group(P<0.05).LVESD,NT-proBNP,cTnI,Lp-PLA2,MMP-9,and IL-6 in both groups decreased after treatment,with more significant resultsin the study group(P<0.05).The proportion of TIMI III grade in the study group was higher than that in the control group(P<0.05),and there was no significant difference in the incidence of drug adverse reactions and postoperative cardiovascular adverse events between the two groups6 months after surgery(P>0.05).Conclusion The combination of alirocumab and ybutimibe in the treatment of STEMI PCI patients is more helpful in reducing blood lipid levels,promoting blood flow perfusion and improving myocardial function,and has good safety.