阿利西尤单抗与依洛尤单抗分别联合阿托伐他汀对冠心病伴高脂血症的疗效对比

Comparison of therapeutic effects of alirocumab and evolocumab separately combined with atorvastatin on coronary heart disease complicated with hyperlipidemia

摘要:

目的 对比阿利西尤单抗、依洛尤单抗联合阿托伐他汀治疗冠心病伴高脂血症的疗效。方法 纳入2022年1月至2024年6月赣州市人民医院收治的84例冠心病伴高脂血症患者，采用奇偶数分组法分为对照组（采用依洛尤单抗与阿托伐他汀治疗）和观察组（采用阿利西尤单抗与阿托伐他汀治疗），每组42例。对比两组患者治疗前后的血脂指标〔甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）〕、颈动脉粥样硬化情况〔颈动脉斑块积分（Crouse积分）、内膜中层厚度（IMT）〕及不良反应发生情况。结果 观察组治疗后的TC、LDL-C较对照组低，HDL-C较对照组高（P＜0.05）；两组治疗后的TG无显著差异（P＞0.05）。观察组治疗后Crouse积分、IMT改善情况优于对照组（P＜0.05）。两组不良反应发生率无显著差异（P＞0.05）。结论 对于冠心病伴高脂血症患者的治疗，使用阿利西尤单抗、依洛尤单抗分别联合阿托伐他汀均能有效降低血脂水平，改善颈动脉粥样硬化斑块，且安全性良好；其中阿利西尤单抗对于血脂及颈动脉粥样硬化斑块的改善优于依洛尤单抗，值得临床重视。

Abstract:

Objective To compare the effects of alirocumab and evolocumab separately combined with atorvastatin in the treatment of coronary heart disease complicated with hyperlipidemia.Methods Eighty-four patients with coronary heart disease and hyperlipidemia admitted to Ganzhou People's Hospital from January 2022 to June 2024 were selected as the research subjects. Using the odd/even number grouping method, they were divided into the control group (42 cases, treated with evolocumab and atorvastatin) and the observation group (42 cases, treated with alirocumab and atorvastatin). Blood lipids 〔triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C)〕, condition of carotid atherosclerosis 〔carotid plaque score (Crouse score) and intima-media thickness (IMT)〕 and the incidence of adverse reactions were compared between the two groups.Results After treatment, the levels of TC and LDL-C in observation group were lower than those in control group, and HDL-C level was higher than that in control group (P＜0.05). There was no significant difference in TG between the groups after treatment (P＞0.05). After treatment, the improvements in Crouse score and IMT were better in observation group than those in control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion For patients with coronary heart disease and hyperlipidemia, alirocumab and evolocumab separately combined with atorvastatin both can effectively lower the levels of blood lipids and improve carotid atherosclerotic plaques, with good safety. Moreover, alirocumab is superior to evolocumab in improving blood lipids and carotid atherosclerotic plaque, which deserves clinical attention.