| 龙朋伟,曹萍,张跃彤,等.PCSK9抑制剂对冠状动脉钙化的影响[J].中国临床保健杂志,2022,25(5):624-627. |
| PCSK9抑制剂对冠状动脉钙化的影响 |
| Impact of PCSK9 inhibitors on coronary calcification |
| 投稿时间：2022-07-02 |
| DOI：10.3969/J.issn.1672-6790.2022.05.010 |
| 中文关键词: 冠心病 冠状动脉疾病 羟甲基戊二酰基CoA还原酶抑制剂 胆固醇,LDL |
| 英文关键词: Coronary disease Coronary artery disease Hydroxymethylglutaryl-CoA reductase inhibitors Cholesterol,LDL 〖FL |
| 基金项目:中央军委后勤保障部卫生局面上项目(21BJZ48) |
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| 中文摘要: |
| 目的 探讨在他汀类药物治疗基础上加用PCSK9抑制剂对低密度脂蛋白胆固醇(LDL-C)水平和冠状动脉钙化的影响。方法 该研究为单中心非随机对照研究,选取2020年9月至2021年3月于北京安贞医院行冠状动脉CT血管造影(CTA)且至少存在1支血管狭窄大于50%的冠心病患者。应用强化他汀类或最大可耐受剂量他汀类药物治疗后LDL-C水平仍然>1 g/L的冠心病患者,在原有他汀类治疗的基础上加用PCSK9抑制剂。在12个月后应用冠脉CTA评价冠状动脉钙化积分变化情况。结果 入选51例患者(他汀类治疗组为28例,阿利西尤单抗组为23例)。基线时,2组患者之间胆固醇、三酰甘油及C反应蛋白(CRP)水平差异无统计学意义。随访12个月时,2组患者LDL-C水平均较基线时显著降低(P<0.001),但PCSK9抑制剂组患者LDL-C降低的幅度显著大于他汀类治疗组[(-1.69±0.52)mmol/L比(-0.92±0.60)mmol/L,P<0.001]。且脂蛋白(a)较基线的变化也显著高于他汀类治疗组[-0.6(-2.3,0.6)比-3.1(-18.0,-1.9),P=0.001]。而他汀类治疗组患者在钙化积分增加程度显著高于PCSK9抑制剂组[10.6(6.3 23.3)比2.9(-6.7 8.3),P<0.001]。结论 在他汀类治疗基础上加用PCSK9抑制剂治疗不但能进一步降低LDL-C水平,同时能够改善冠状动脉钙化进展。 |
| 英文摘要: |
| Objective To investigate the effect of PCSK9 inhibitor on low-density cholesterol level and coronary artery calcification on the basis of statin therapy.Methods Eligible patients underwent coronary CT with moderate coronary lesions and elevated LDL cholesterol levels with either alirocumab plus statin therapy or standard statin therapy were enrolled.Results Fifty one patients were identified in the study (statin group,n=28,alirocumab group,n=23).Greater decreases in the changes of lipoprotein (a) levels were observed in the alirocumab group compared to the statin group[-0.6(-2.3,0.6) vs.-3.1(-18.0,-1.9),P=0.001].The study also demonstrated a significant increase of calcium scoreof patients in statin group,whereas the changesof calcium score were significantly lower in the alirocumab group compared to the statin group [10.6(6.3 23.3) vs.2.9(-6.7 8.3),P<0.001].Conclusion The administration of the PCSK9 inhibitors to statin-treated patients produce significantly lower rate of calcium progression. |
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