依洛尤单抗在非ST段抬高型急性冠状动脉综合征患者PCI术后的应用效果研究

摘要/Abstract

摘要： 目的：探讨依洛尤单抗在非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者经皮冠状动脉介入（PCI）术后的应用效果。方法：选择2021年1月至2023年1月我院收治的86例NSTE-ACS患者作为研究对象，按照随机数字表法分为观察组和对照组两组，每组各43例。两组患者均接受PCI治疗，对照组患者术后给予阿托伐他汀钙片治疗，观察组患者在对照组治疗的基础上联合依洛尤单抗治疗。治疗2周后，比较两组患者的临床治疗效果。记录治疗前和治疗后患者心功能指标[左心室射血分数（LVEF）、左心室整体纵向应变量（GLS）]、血脂指标[血清胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]、血管内皮功能指标[一氧化氮（NO）、内皮素-1（ET-1）、血管性血友病因子（vWF）]及血清炎症因子[超敏-C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）]变化。统计两组患者不良反应发生情况。结果：观察组患者总有效率为93.02%，高于对照组的76.74%（P＜0.05）。治疗后，两组患者LVEF水平均较治疗前升高，GLS水平均较治疗前降低，且观察组患者LVEF水平升高幅度和GLS水平降低幅度均高于对照组（P＜0.05）。治疗后，两组患者血脂指标TC、TG、LDL-C水平均较治疗前降低，HDL-C水平均较治疗前升高，且观察组患者TC、TG、LDL-C水平降低幅度、HDL-C水平升高幅度均高于对照组（P＜0.05）。治疗后，两组患者血管内皮功能指标NO水平均较治疗前升高，ET-1、vWF水平均较治疗前降低，且观察组患者NO水平升高幅度、ET-1、vWF水平降低幅度均高于对照组（P<0.05）。治疗后，两组患者血清hs-CRP、TNF-α、IL-6水平均较治疗前降低，且观察组患者hs-CRP、TNF-α、IL-6水平降低幅度均高于对照组（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：依洛尤单抗应用于接受PCI治疗的NSTE-ACS患者中可有效改善左心室收缩功能及血管内皮功能，调节血脂水平，抑制炎症反应，安全性高。

关键词: 急性冠状动脉综合征, 非ST段抬高型, 经皮冠状动脉介入术, 依洛尤单抗, 疗效

Abstract: Objective：To investigate the efficacy of evolocumab in patients with non-ST-segment elevation type acute coronary syndrome (NSTE-ACS) after percutaneous coronary intervention (PCI).Methods：A total of 86 patients with NSTE-ACS admitted in our hospital from January 2021 to January 2023 were selected as the research objects， and were divided into the observation group and the control group according to random number table method， with 43 patients in each group. Both groups received PCI treatment. The control group was treated with atorvastatin calcium tablet after surgery， and the observation group was treated with evolocumab on the basis of the control group. After 2 weeks of treatment， the therapeutic effects of the two groups were compared.The cardiac function indexes [left ventricular ejection fraction (LVEF)， left ventricular global longitudinal strain (GLS)]， blood lipid indexes [serum cholesterol (TC)， triglyceride (TG)， low-density lipoprotein cholesterol (LDL-C)， high-density lipoprotein cholesterol (HDL-C)]，vascular endothelial function indicators [nitric oxide (NO)， endothelin-1 (ET-1)， vascular haemophilia factor (vWF)] and serum inflammatory factors [high-sensitivity C-reactive protein (hs-CRP)， tumor necrosis factor-α (TNF-α)， and Interleukin 6 (IL-6)]of the two groups of patients were recorded before and after treatment.The occurrence of adverse reactions in the two groups was recorded. Results：The total effective rate of the observation group was 93.02%，which was higher than that of the control group (76.74%， P＜0.05).After treatment， the LVEF level of patients in both groups was higher than that before treatment， while the GLS level of patients in both groups was lower than that before treatment， and the increase of LVEF level and the decrease of GLS level in the observation group were greater than those of the control group(P＜0.05). After treatment， the levels of TC， TG and LDL-C of patients in both groups were lower than those before treatment， while the HDL-C levels were higher than those before treatment， and the decreas of TC， TG and LDL-C levels and the increase of HDL-C level in the observation group were greater than those of the control group(P＜0.05).After treatment， the NO level of patients in both groups was higher than that before treatment， while the levels of ET-1 and vWF were greater than those before treatment， and the increase of NO level and the decreas of ET-1 and vWF levels in the observation group were greater than those of the control group (P＜0.05). After treatment， the levels of hs-CRP， TNF-α， and IL-6 of patients in both groups were lower than those before treatment， and the decreas of hs-CRP， TNF-α and IL-6 of patients in the observation group were greater than those of the control group (P＜0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P＞0.05). Conclusion：The application of evolocumab in NSTE-ACS patients undergoing PCI treatment can effectively improve left ventricular systolic function and vascular endothelial function， regulate blood lipid levels， inhibit inflammatory reactions， and has high safety.

Key words: Acute coronary syndrome, Non-ST-segment elevation type, Percutaneous coronary intervention, Evolocumab, Efficacy

中图分类号:

倪烨, 赵娅, 张必利. 依洛尤单抗在非ST段抬高型急性冠状动脉综合征患者PCI术后的应用效果研究[J]. 中国医药导刊, 2023, 25(12): 1253-1258.

NI Ye, ZHAO Ya, ZHANG Bili. Study on the Efficacy of Evolocumab in Patients with Non-ST-Segment Elevation Type Acute Coronary Syndrome After PCI#br#[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(12): 1253-1258.

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