依洛尤单抗联合瑞舒伐他汀在急性冠脉综合征PCI术后治疗中的临床效果及对患者相关指标的影响

Clinical effects of evolocumab combined with rosuvastatin for post-pci treatment in acute coronary syndrome and its impact on patient-related indicators

目的观察依洛尤单抗联合瑞舒伐他汀在急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后治疗中的临床效果及对患者相关指标的影响。方法选取2021年2月—2023年2月云南省阜外心血管病医院收治的ACS患者94例,采用随机数字表法分为联合组和单一组,每组47例。单一组予瑞舒伐他汀钙片治疗,联合组在单一组基础上联合依洛尤单抗注射液治疗,2组均治疗3个月后比较临床效果,治疗前后血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、炎性因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、N末端B型钠尿肽前体(NT-proBNP)]水平变化,以及不良心血管事件。结果联合组治疗总有效率为97.87%,高于单一组的80.85%(χ^(2)=7.162,P=0.007);治疗3个月后,2组TG、TC、LDL-C、hs-CRP、IL-6、TNF-α、CK-MB、cTnI、NT-proBNP水平均较治疗前降低,且联合组低于单一组(P<0.05或P<0.01);联合组不良心血管事件总发生率为12.78%,低于单一组的29.79%(χ^(2)=4.065,P=0.044)。结论依洛尤单抗联合瑞舒伐他汀在ACS患者PCI术后治疗中的临床效果肯定,利于改善患者血脂及炎性因子水平,改善心肌损伤状况,且不良心血管事件发生风险低。

Objective To observe the clinical effects of evolocumab combined with rosuvastatin in the post-pci treatment of patients with acute coronary syndrome(ACS)and its impact on patient-related indicators.Methods Ninety-four ACS patients admitted to Fuwai Yunnan Hospital CAMS from February 2021 to February 2023 were selected and randomly divided into a combination group and a monotherapy group using a random number table,with 47 cases in each group.The monotherapy group was treated with rosuvastatin calcium tablets,while the combination group received evolocumab injection in addition to the treatment given to the monotherapy group.After 3 months of treatment,clinical outcomes between the two groups were compared,as well as changes in lipid levels(TG,TC,LDL-C),inflammatory factors(hs-CRP,IL-6,TNF-α),myocardial injury biomarkers(CK-MB,cTnI,NT-proBNP)before and after treatment,and incidence of adverse cardiovascular events.Results The total effective rate of treatment in the combination group was 97.87%,significantly higher than the 80.85%in the monotherapy group(χ^(2)=7.162,P=0.007).After 3 months of treatment,both groups showed reductions in levels of TG,TC,LDL-C,hs-CRP,IL-6,TNF-α,CK-MB,cTnI,and NT-proBNP compared to before treatment,with levels in the combination group lower than those in the monotherapy group(P<0.05 or P<0.01).The total incidence of adverse cardiovascular events in the combination group was 12.78%,lower than the 29.79%in the monotherapy group(χ^(2)=4.065,P=0.044).Conclusion Evolocumab combined with rosuvastatin demonstrates positive clinical efficacy in post-PCI treatment of ACS patients,beneficial for improving lipid and inflammatory factors levels,improving myocardial injury status,and reducing the risk of adverse cardiovascular events.