河南科技大学第一附属医院心内科;
目的 初步探讨前蛋白转化酶枯草杆菌蛋白酶/kexin 9(PSCK9)抑制剂（Evolocumab）对急性冠脉综合征（ACS）介入治疗患者斑块稳定性的影响。方法 本研究为回顾性、单中心、观察性队列研究。纳入2021年1月至2022年12月就诊于河南科技大学第一附属医院心内科的90例接受经皮冠状动脉介入治疗（PCI）的ACS患者。所有患者在ACS发作后至少24 h开始接受瑞舒伐他汀10 mg/d。联合用药组患者在ACS发作后1周接受Evolocumab（每2周140 mg）治疗。他汀类单药治疗组患者仅服用瑞舒伐他汀。在急诊PCI后4周和12周，进行光学相干断层扫描（OCT）以评估Evolocumab对纤维帽厚度（FCT）以及动脉粥样硬化斑块进展的影响。结果 12周的随访中，与他汀类药物单药治疗组相比，联合用药组的低密度脂蛋白胆固醇（LDL-C）降低，高密度脂蛋白胆固醇（HDL-C）升高（P<0.05）。与他汀类药物单药治疗组相比，联合用药组总胆固醇（TC）和LDL-C的降低值（δTC和δLDL-C）更低，但同时HDL-C升高值（δHDL-C）更高（P<0.05）。OCT分析显示，与他汀类单药治疗组相比，联合用药组随访4周时的最小FCT更大（P<0.05）。随访12周时，联合用药组的最小FCT大于他汀类单药治疗组，同时最大脂质弧和脂质斑块长度低于他汀类单药治疗组（P<0.05）。结论 在他汀类药物治疗中加入PCSK9抑制剂可能会导致FCT增加和富含脂质的斑块的消退，同时LDL-C水平降低程度更显著。
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基本信息:
DOI：
中图分类号:R541.4
引用信息:
[1]刘庆力,杨丽,牛少琼等.PCSK9抑制剂对急性冠状动脉综合征介入治疗患者斑块稳定性的影响[J].中国循证心血管医学杂志,2025,17(02):180-184.
基金信息:
河南省医学科技公关计划联合共建项目(LHGJ20210584)