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依洛尤单抗联合阿托伐他汀治疗冠心病临界病变的临床观察
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| 篇名： | 依洛尤单抗联合阿托伐他汀治疗冠心病临界病变的临床观察 |
| TITLE： | Clinical observation of evolocumab combined with atorvastatin in the treatment of borderline coronary artery disease |
| 摘要： | 目的 观察依洛尤单抗联合阿托伐他汀治疗冠心病（CHD）临界病变患者的临床疗效。方法采用回顾性队列研究，收集南阳医学高等专科学校第一附属医院2021年8月至2024年6月确诊为CHD临界病变的住院患者342例，根据治疗方案将患者分为对照组（采用阿托伐他汀治疗，190例）和试验组（采用依洛尤单抗联合阿托伐他汀治疗，152例）。经倾向评分匹配后，比较两组患者治疗前和治疗1年后的血脂指标、高敏C反应蛋白（hs-CRP）、冠脉血管内超声指标数据及心血管不良事件发生率。结果最终共纳入295例（对照组158例、试验组137例）患者进行分析。治疗1年后，相比同期对照组，试验组患者的总胆固醇、甘油三酯、低密度脂蛋白胆固醇及hs-CRP水平均显著降低（P＜0.05），高密度脂蛋白胆固醇水平显著升高（P＜0.05），血管腔直径、血管腔面积、最小管腔面积均显著增大（P＜0.05），斑块面积及斑块负荷均显著减小（P＜0.05）。试验组患者总不良事件的发生率显著低于对照组（P＜0.05）。结论依洛尤单抗联合阿托伐他汀能显著改善CHD临界病变患者的冠脉血管狭窄、斑块负荷，并降低心血管不良事件的发生率。 |
| ABSTRACT： | OBJECTIVE To observe the clinical efficacy of evolocumab combined with atorvastatin in the treatment of patients with borderline coronary heart disease （CHD）. METHODS In this retrospective cohort study， 342 hospitalized patients diagnosed with borderline CHD were enrolled in the First Affiliated Hospital of Nanyang Medical College from August 2021 to June 2024， and divided into control group （treated with atorvastatin， 190 cases） and trial group （treated with evolocumab combined with atorvastatin， 152 cases） according to therapeutic regimen. Blood lipid indexes， high-sensitivity C-reactive protein （hs-CRP） and intravascular ultrasound of the coronary artery at baseline and after 1 year of treatment， and incidence of cardiovascular adverse events were compared after propensity score matching. RESULTS A total of 295 patients （158 in control group and 137 in trial group） were finally included in the analysis. One year after the treatment， compared with control group， total cholesterol， triglycerides， low-density lipoprotein cholesterol and hs-CRP levels were decreased significantly in trial group （ P ＜0.05）， whereas high-density lipoprotein cholesterol level was increased significantly （ P ＜0.05）. The lumen diameter， lumen area， and the minimum lumen area were significantly increased （ P ＜0.05）， while plaque area and plaque burden were significantly decreased （ P ＜0.05）. Overall incidence of adverse events in trial group was significantly lower than that in control group （ P ＜0.05）. CONCLUSIONS Evolocumab combined with atorvastatin can significantly improve coronary luminal narrowing and reduce plaque burden， as well as reduce the incidence of cardiovascular adverse events in patients with borderline CHD. |
| 期刊： | 2026年第37卷第10期 |
| 作者： | 苏蕊雅；王力闯；张鸥；曾显峰；文贤 |
| AUTHORS： | SU Ruiya，WANG Lichuang，ZHANG Ou，ZENG Xianfeng，WEN Xian |
| 关键字： | 依洛尤单抗；阿托伐他汀；临界病变；冠心病；冠状动脉斑块；管腔狭窄；前蛋白转化酶枯草溶菌素9抑制剂 |
| KEYWORDS： | evolocumab； atorvastatin； borderline lesion； coronary heart disease； coronary artery plaque； luminal stenosis； |
| 阅读数： | 2 次 |
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