目的 探讨依洛尤单抗对急性广泛前壁心肌梗死经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后血脂和左心功能的影响.方法 回顾性分析 2021 年 1 月至 2023 年 7 月于聊城市人民医院就诊的急性广泛前壁心肌梗死并行急诊PCI的患者 52 例,根据患者的术后的调脂方案分为两组,其中单纯服用瑞舒伐他汀者为对照组,共 24 例;联合瑞舒伐他汀和依洛尤单抗治疗者为观察组,共 28 例.分别于术前及术后 6 个月测定患者血总胆固醇(TC),甘油三酯(TG),低密度脂蛋白(LDL),高密度脂蛋白(HDL),C反应蛋白(CRP),B型钠尿肽(BNP).行心脏彩超检查测定左室射血分数(LVEF),左室舒张末内径(LVEDD).结果 术后 6 个月,与对照组相比,观察组TC(3.28±0.73mmol/L vs 4.45±0.99mmol/L,t=-4.90,P<0.001)、TG(1.09±0.33mmol/L vs 1.61±1.07mmol/L,t=-2.44,P=0.02)、LDL(1.18±0.12mmol/L vs 2.05±0.35mmol/L,t=-11.59,P<0.001)、BNP(263.57±119.12pg/mL vs 575.58±219.99pg/mL,t=-6.21,P<0.001)、CRP(1.19±1.03mg/L vs 1.74±0.66mg/L,t=-2.23,P=0.02)明显降低,HDL(1.97±0.34mmo/L vs 1.66±0.29mmol/L,t=3.472,P=0.001)明显升高,LVEDD(35.57±2.83mm vs 40.83±4.35mm,t=-5.074,P<0.001)明显缩小,LVEF[(59.36±6.92%)vs(52.50±7.96%),t=3.32,P=0.002]明显升高.结论 在急性广泛前壁心肌梗死中联合应用依洛尤单抗和他汀类药物可进一步显著降低患者的血脂和炎症水平,而且能进一步改善患者左心室功能.
Effects of evolocumab on blood lipid and left ventricular function in patients with acute extensive anterior myocardial infarction after percutaneous coronary intervention
Objective To investigate the effect of evolocumab on left ventricular function after percutaneous coro-nary intervention(PCI)for acute extensive anterior myocardial infarction.Methods Fifty-two patients with acute ante-rior myocardial infarction and emergency PCI in Liaocheng People's Hospital from January 2021 to July 2023 were col-lected.According to the postoperative lipid regulation scheme,the patients were divided into two groups:the control group(24 cases)treated with rosuvastatin alone;the observation group(28 cases)treated with rosuvastatin combined with evolocumab.The blood total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipopro-tein(HDL),C-reactive protein(CRP),and B-type natriuretic peptide(BNP)were measured before and 6 months after surgery.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)were meas-ured by echocardiography.Results 6 months after surgery,compared with the control group,TC(3.28±0.73mmol/l vs 4.45±0.99mmol/l,t=-4.90,P<0.001)、TG(1.09±0.33mmol/l vs 1.61±1.07mmol/l,t=-2.44,P=0.02)、LDL(1.18±0.12mmol/l vs 2.05±0.35mmol/l,t=-11.59,P<0.001)、BNP(263.57±119.12pg/ml vs 575.58±219.99pg/ml,t=-6.21,P<0.001)、CRP(1.19±1.03mg/L vs 1.74±0.66mg/L,t=-2.23,P=0.02)in the observation group were significantly lower,HDL(1.97±0.34mmol/L vs 1.66±0.29mmol/L,t=3.47,P=0.001)was significantly increased,LVEDD(35.57±2.83mm vs 40.83±4.35mm,t=-5.07,P<0.001)was significantly reduced,and LVEF[(59.36±6.92)%vs(52.50±7.96)%,t=3.32,P=0.002]was significantly increased(P<0.05).Conclusions The combined application of evolocumab and statins in acute extensive anterior myocardial infarction can further significantly reduce the blood lipid and inflammatory levels of patients,and can further improve the left ventricular function of patients.
EvolocumabAcute extensive anterior myocardial infarctionPCILeft ventricular function
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