摘要
目的观察依洛尤单抗在超高危动脉粥样硬化性心血管疾病(ASCVD)患者中的疗效。方法选取2020年10月至2022年7月于解放军总医院京西医疗区厢红旗门诊部就诊并接受治疗的已确诊的超高危ASCVD患者54例,均服用中等强度他汀联合依折麦布降脂治疗,低密度脂蛋白胆固醇(LDL-C)不达标。将入选患者随机分为他汀加强组(27例)和依洛尤单抗组(27例),他汀加强组治疗方案调整为阿托伐他汀钙30 mg口服qd或瑞舒伐他汀钙15 mg口服qd,继续原方案中依折麦布10 mg口服qd;依洛尤单抗组将原方案中的依折麦布改为依洛尤单抗140 mg皮下注射q2w,继续原方案中阿托伐他汀钙20 mg口服qd或瑞舒伐他汀钙10 mg口服qd。两组均治疗3个月,观察患者治疗前后总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、LDL-C水平变化,并观察记录不良反应。结果治疗后,依洛尤单抗组LDL-C为(0.85±0.09)mmol/L,他汀加强组LDL-C为(1.92±0.19)mmol/L,两组LDL-C较治疗前均明显下降,依洛尤单抗组低于他汀加强组,差异均有统计学意义(P<0.05),但他汀加强组降低TG、升高HDL-C的效果更好(P<0.05)。两组治疗不良反应轻微,且为一过性,总体安全。结论依洛尤单抗对于血脂不达标的超高危ASCVD患者降低LDL-C疗效明显,全部达标。
Objective To observe the efficacy of evolocumab in patients with extremely high-risk atherosclerotic cardiovascular disease(ASCVD).Methods From October 2020 to July 2022,54 patients with confirmed extremely high-risk atherosclerotic cardiovascular disease who received treatment in Xianghongqi Outpatient Department of Jingxi Medical District of PLA General Hospital were selected.All of them were treated with moderate-intensity statins combined with ezeimibe lipid-lowering therapy,and their low-density lipoprotein cholesterol(LDL-C)was not up to standard.The enrolled patients were randomly divided into the statin enhanced group(27 cases)and the evolocumab group(27 cases).The treatment regimen of the statin enhanced group was adjusted to atorvastatin calcium 30 mg oral qd or rosuvastatin calcium 15 mg oral qd,while the original regimen of ezetimibe 10 mg oral qd was continued.In the evolocumab group,ezetimibe in the original regimen was changed to evolocumab 140 mg subcutaneous q2w,and the original regimen was continued with atorvastatin calcium 20 mg oral qd or rosuvastatin calcium 10 mg oral qd.Both groups were treated for 3 months.Changes in total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and LDL-C levels before and after treatment were observed,and adverse reactions were recorded.Results After treatment,LDL-C was(0.85±0.09)mmol/L in evolocumab group and(1.92±0.19)mmol/L in statin enhanced group.LDL-C was significantly decreased in both groups compared with before treatment,and the effect was more significant in the evolocumab group,the difference being statistically significant(P<0.05),but the effect of lowering TG and increasing HDL-C was better in statin enhanced group(P<0.05).The adverse reactions of the two groups were mild and transient,the treatment being generally safe.Conclusion In this study,the effect of evolocumab on lowering LDL-C in extremely high-risk ASCVD patients with substandard blood lipids is obvious,and all patients reach the standard.
作者
张辉
王利
Zhang Hui;Wang Li(Xianghongqi Outpatient Department,Jingxi Medical District of PLA General Hospital,Beijing 100091,China)
出处
《实用药物与临床》
CAS
2023年第5期417-421,共5页
Practical Pharmacy and Clinical Remedies
作者简介
通讯作者:王利。
