依洛尤单抗联合左卡尼汀在急性ST段抬高型心肌梗死患者术后的应用效果

Application effect of evolocumab combined with levocarnitine in patients with acute ST-elevation myocardial infarction after surgery

目的探讨依洛尤单抗联合左卡尼汀在急性ST段抬高型心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)术后的应用效果。方法选取120例STEMI患者为研究对象,随机分为治疗组60例和对照组60例。对照组给予STEMI基本治疗方法加用左卡尼汀,治疗组在对照组基础上加用依洛尤单抗。比较2组患者治疗前后的治疗有效率、心功能指标[B型尿钠肽(BNP)、左室射血分数(LVEF)]、冠状动脉微循环情况[心肌梗死溶栓治疗临床试验(TIMI)危险评分、前蛋白转化酶枯草溶菌素9(PCSK9)和低密度脂蛋白胆固醇(LDL-C)]以及不良反应发生率。结果治疗后,治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,2组BNP水平低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05);2组LVEF高于治疗前,且治疗组高于对照组,差异有统计学意义(P<0.05)。治疗后,2组的TIMI危险评分降低,且治疗组低于对照组,差异有统计学意义(P<0.05);2组的PSCK9与LDL-C水平低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论依洛尤单抗联合左卡尼汀对STEMI患者急诊PCI术后的心功能和冠状动脉微循环的改善效果较好,且安全性较高。

Objective To investigate the effect of evolocumab combined with levocarnitine after emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 120 STEMI patients were selected and randomly divided into treatment group(60 cases)and control group(60 cases).The control group was given STEMI basic treatment plus levocarnitine,and the treatment group was given evolocumab on the basis of the control group.The therapeutic effectiveness,coronary artery microcirculation[B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)],coronary arteriole status[Thrombolysis in Myocardial Infarction(TIMI)risk score,preprotein converting enzyme subtilysin 9(PCSK9)and low density lipoprotein cholesterol(LDL-C)]and incidence of adverse reactions were compared between the two groups before and after treatment.Results After treatment,the total effective rate of treatment group was significantly higher than that of control group(P<0.05).After treatment,BNP level in two groups was significantly lower than before treatment,and the level in the treatment group was significantly lower than that in the control group(P<0.05);LVEF in the two groups was significantly higher than before treatment,and the treatment group was significantly higher than the control group(P<0.05).After treatment,the TIMI risk score of the two groups was significantly decreased,and the treatment group was significantly lower than the control group(P<0.05).The levels of PSCK9 and LDL-C in the two groups were significantly lower than before treatment,and the treatment group was significantly lower than the control group(P<0.05).After treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Evolocumab combined with levocarnitine can improve cardiac function and coronary microcirculation in STEMI patients after emergency PCI,and has high safety.