依洛尤单抗联合瑞舒伐他汀治疗冠心病的疗效及对患者血脂和炎症因子的影响

Efficacy of evolocumab combined with rosuvastatin in the treatment of coronary heart disease and its effects on blood lipid levels and inflammatory factors

目的:探讨依洛尤单抗联合瑞舒伐他汀治疗冠心病的效果。方法:选择180例冠心病患者为研究对象,按照不同的治疗方式将患者分为对照组与观察组,每组各90例,分别予以瑞舒伐他汀治疗和依洛尤单抗联合瑞舒伐他汀治疗,两组均治疗6个月。对两组血脂、心功能、炎症指标[超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)]进行比较,并统计两组患者不良心血管事件(MACE)和不良反应发生情况。结果:治疗后,观察组患者总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)和脂蛋白a[Lp(a)]较对照组更低(P<0.05),且LDL-C达标率高于对照组(91.95%vs.73.26%,P<0.05)。治疗后,观察组患者左室射血分数比对照组更高(P<0.05),血浆N末端B型脑纳利肽前体和血清hs-CRP、IL-6水平更低(P<0.05)。随访6个月,观察组患者MACE发生率比对照组更低(5.75%vs.15.12%,P<0.05)。两组患者不良反应总发生率无统计学差异(P>0.05)。结论:依洛尤单抗联合瑞舒伐他汀治疗冠心病,对于患者的降脂作用、炎症缓解、心功能提高效果更显著,MACE发生率更低。

Objective:To investigate the effect of evolocumab combined with rosuvastatin in patients with coronary heart disease.Methods:180 patients with coronary heart disease were divided into control group and observation group according to different treatment methods,with 90 cases in each group.The control group was treated with rosuvastatin,and the observation group was treated with evolocumab combined with rosuvastatin.Both groups were treated for 6 months.The blood lipid,cardiac function and inflammatory indexes[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)]of the two groups were compared and analyzed,and the incidence of adverse cardiovascular events(MACE)and adverse reactions of the two groups were counted.Results:After treatment,the total cholesterol,triglyceride,low density lipoprotein cholesterol(LDL-C)and lipoprotein a[Lp(a)]in the observation group were lower than those in the control group(P<0.05),and the LDL-C compliance rate was higher than that in the control group(91.95%vs.73.26%,P<0.05).After treatment,compared with the control group,the left ventricular ejection fraction of the observation group was higher(P<0.05),and the levels of plasma N-terminal B-type brain natriuretic peptide precursor and serum hs-CRP and IL-6 were lower(P<0.05).Compared with the control group,the incidence of MACE in the observation group was lower after 6 months of follow-up(5.75%vs.15.12%,P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:The lipid-lowering effect of evolocumab combined with rosuvastatin in patients with coronary heart disease is significant,which can achieve more effective inflammation relief,cardiac function improvement and lower incidence of MACE.