阿利西尤单抗降低血脂不达标冠心病患者LDL-C的有效性及对动脉粥样硬化斑块的影响
Efficacy of Alirocumab in reducing LDL-C in patients with coronary heart disease and substandard blood lipids and its effect on atherosclerotic plaque
曾秋玲 1温汝军 1蒋超婷 1黄莹1
作者信息
- 1. 深圳市龙华区人民医院药学部,广东 深圳 518110
- 折叠
摘要
目的:探讨阿利西尤单抗降低血脂不达标冠心病(CHD)患者低密度脂蛋白胆固醇(LDL-C)的临床效果及对动脉粥样硬化斑块的影响.方法:选择2017年9月至2021年3月期间深圳市龙华区人民医院收治的血脂不达标的CHD患者127例,根据是否接受阿利西尤单抗治疗分为联合组(46例)和对照组(81例).对照组维持原他汀类药物治疗方案不变,联合组在原他汀类药物治疗方案基础上应用PCSK9抑制剂阿利西尤单抗注射液,75mg皮下注射,每2周一次.两组均进行3个月的治疗,并随访12个月.比较两组治疗前、随访12个月后总胆固醇(TC)和LDL-C水平,斑块纤维帽厚度、脂质斑块弧度、脂质斑块长度、最小管腔横截面积,以及不良反应和临床终点事件情况.结果:随访12个月后,与对照组比较,联合组血浆TC[(3.48±1.04)mmol/L比(2.29±0.76)mmol/L]、LDL-C[(2.08±0.53)mmol/L 比(1.27±0.41)mmol/L]水平均显著降低,脂质斑块弧度[(107.22±13.29)° 比(92.65±11.81)°]、脂质斑块长度[(5.45±0.89)mm 比(4.84±0.82)mm]显著减小,斑块纤维帽厚度[(123.60±14.87)μm比(131.46±14.29)μm]和最小管腔横截面积[(2.51±0.37)mm2比(2.69±0.33)mm2]显著增加(P均＜0.01).两组不良反应发生率(x2=0.428,P=0.513)和临床终点事件发生率(x2=0.253,P=0.615)均无显著差异.结论:阿利西尤单抗可显著降低血脂不达标的CHD患者LDL-C水平,增加斑块纤维帽的厚度和管腔横截面积,降低斑块内部脂质负荷,提高斑块的稳定性,且安全性良好.
Abstract
Objective:To investigate the clinical effect of Alirocumab in reducing low density lipoprotein cholesterol(LDL-C)in patients with coronary heart disease(CHD)and substandard blood lipids and its effect on atheroscle-rotic plaque.Methods:A total of 127 CHD patients with substandard blood lipids who were treated in Shenzhen Longhua District People's Hospital between September 2017 and March 2021 were selected.According to patients re-ceived Alirocumab therapy or not,they were divided into control group(n=81)and combined group(n=46).The control group remained original statin therapeutic regimen,while combined group received additional PCSK9 inhibi-tor Alirocumab injection based on original statin therapeutic regimen,75mg subcutaneously,once every 2 weeks.Both groups were treated for 3 months,then followed up for 12 months.Levels of total cholesterol(TC)and LDL-C,plaque fiber cap thickness,lipid plaque radian,lipid plaque length and minimum lumen cross-sectional area before and after 12-month follow-up,and incidence of adverse reactions and clinical endpoint events were com-pared between two groups.Results:After 12-month follow-up,compared with control group,combined group had significant lower plasma levels of TC[(3.48±1.04)mmol/L vs.(2.29±0.76)mmol/L],LDL-C[(2.08±0.53)mmol/L vs.(1.27±0.41)mmol/L],lipid plaque radian[(107.22±13.29)° vs.(92.65±11.81)°]and lipid plaque length[(5.45±0.89)mm vs.(4.84±0.82)mm],and significant higher plaque fiber cap thickness[(123.60±14.87)μm vs.(131.46±14.29)μm]and minimum lumen cross-sectional area[(2.51±0.37)mm2 vs.(2.69±0.33)mm2](P＜0.01 all).There was no significant difference in incidence rates of adverse reactions(x2=0.428,P=0.513)and clinical endpoint events(x2=0.253,P=0.615)between two groups.Conclusion:Alirocumab can significantly reduce LDL-C level,increase the plaque fiber cap thickness and lumen cross-section-al area,reduce the internal lipid load of plaque and improve the stability of plaque with good safety in CHD patients with substandard blood lipids.
关键词
冠心病/脂蛋白类,LDL/斑块,动脉粥样硬化/阿利西尤单抗Key words
Coronary disease/Lipoproteins,LDL/Plaque,Atherosclerotic/Alirocumab引用本文复制引用
出版年
2024
NETL
NSTL
万方数据