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中国临床药理学与治疗学 ›› 2022, Vol. 27 ›› Issue (4): 409-417.doi: 10.12092/j.issn.1009-2501.2022.04.009

• 心血管疾病药物治疗最新研究进展 • 上一篇    下一篇

PCSK9抑制剂对冠心病患者血脂及炎症因子的影响

王瑞杰,王亮,徐丹,周淼淼,李纪明   

  1. 上海市东方医院心内科,上海 200120
  • 出版日期:2022-04-26 发布日期:2022-05-17
  • 通讯作者: 李纪明,男,博士,主任医师,博士生导师,主要研究方向:心力衰竭的分子机制研究。 E-mail: ljm13303818674@126.com
  • 作者简介:王瑞杰,本科,在读硕士生,主要研究方向:冠心病的诊疗。 E-mail: 1747207619@qq.com
  • 基金资助:
    国家自然科学基金(81870296);浦东新区卫生健康委员会临床高峰学科建设计划项目(PWYgf2021-01)

Effects of PCSK9 inhibitors on blood lipids and inflammatory factors in patients with coronary heart disease

WANG Ruijie, WANG Liang, XU Dan, ZHOU Miaomiao, LI Jiming   

  1. Department of Cardiology, Shanghai East Hospital, Shanghai 200120, China
  • Online:2022-04-26 Published:2022-05-17

摘要: 目的:观察PCSK9抑制剂对冠心病患者血脂水平及常见炎症因子的影响。方法:回顾性分析2020年4月至2021年6月期间入住上海市东方医院心内科的201例冠心病患者的临床资料。根据患者用药情况分为PCSK9抑制剂治疗组(他汀+PCSK9抑制剂,n=101)和对照组(单纯他汀治疗组,n=100),治疗1个月后复查血脂、血常规、C反应蛋白(CRP)及纤维蛋白原(FIB)等指标,比较用药前后血脂及炎症因子的变化情况。结果:治疗前,两组患者血脂、血常规、CRP及FIB等指标无统计学差异(P>0.05),治疗1个月后PCSK9抑制剂组同治疗前相比,总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、小而密低密度脂蛋白(sdLDL)及脂蛋白(a)(Lp(a))水平均显著降低(P<0.05);白细胞计数(WBC)、CRP、中性粒细胞计数(N)、FIB水平均显著降低(P<0.05)。PCSK9抑制剂组同对照组相比,TC、高密度脂蛋白(HDL)、LDL-C、CRP、FIB水平有明显变化(P<0.05),结果有统计学意义。结论:PCSK9抑制剂不但可以降低LDL-C水平,对改善Lp(a)水平也有效果。PCSK9抑制剂可以降低CRP、FIB水平,提示可以部分改善冠心病患者外周血的炎症水平。

关键词: PCSK9抑制剂, 冠心病, 血脂, 炎症因子

Abstract: AIM: To observe the effect of PCSK9 inhibitors on blood lipid levels and common inflammatory factors in patients with coronary heart disease. METHODS: The clinical data of 201 patients with coronary heart disease who were admitted to the Department of Cardiology of Shanghai East Hospital from April 2020 to June 2021 were retrospectively analyzed. The patients were divided into PCSK9 inhibitor treatment group (101 cases: statin + PCSK9 inhibitor) and control group (100 cases: statin treatment only) according to their medication status. Blood lipids, blood routine, CRP and FIB were re-examined after 1 month of treatment. The changes of blood lipids and inflammatory factors before and after treatment were compared. RESULTS: Before treatment, there was no significant difference in blood lipids, blood routine, CRP and FIB between the two groups (P>0.05). The levels of sdLDL and Lp(a) were significantly decreased (P<0.05); the levels of WBC, CRP, N and FIB were significantly decreased (P<0.05). Compared with the control group, the levels of TC, HDL, LDL-C, CRP and FIB in the PCSK9 inhibitor group were significantly changed (P<0.05), and the results were statistically significant. CONCLUSION: PCSK9 inhibitors can not only reduce LDL-C levels, but also reduce Lp(a) levels. PCSK9 inhibitors can reduce CRP and FIB levels, suggesting that it can partially improve inflammation in peripheral blood in patients with coronary heart disease.

Key words: PCSK9 inhibitor, coronary heart disease, blood lipids, inflammatory factors

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