摘要
目的观察依洛尤单抗在颈动脉易损斑块治疗中的治疗价值。方法纳入2022年4月至2024年4月无锡市第二人民医院收治的90例合并高胆固醇血症的颈动脉易损斑块患者,随机分为观察组(n=45)及对照组(n=45)。两组患者均予规范降脂治疗,其中观察组联合依洛尤单抗注射液,两组患者规律治疗6个月。比较并分析两组患者治疗前及治疗后血脂水平、颈动脉易损斑块相关指标及不良事件情况。结果治疗后,两组患者低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、超敏C反应蛋白(hs-CRP)水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组甘油三酯(TG)水平较治疗前降低,且低于同时段对照组,差异有统计学意义(P<0.05);两组治疗前后组内和组间高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05);观察组LDL-C达标率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组颈动脉内中膜厚度(IMT)、斑块面积及斑块厚度显著小于同组治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗前后组内和组间斑块数目比较,差异无统计学意义(P>0.05)。治疗后,两组斑块类型分布比较,差异有统计学意义(P<0.05)。两组治疗期间药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论常规他汀类药物治疗基础上联合依洛尤单抗能够有效逆转颈动脉粥样硬化,提高易损斑块的稳定性,是潜在的降低颈动脉易损斑块破裂的风险的有效治疗手段。
Objective To evaluate the therapeutic value of evolocumab in the treatment of vulnerable carotid plaques.Methods A total of 90 patients with vulnerable carotid plaques complicated by hypercholesterolemia who were admitted to Wuxi Second People’s Hospital from April 2022 to April 2024 were enrolled and randomly assigned to an observation group(n=45)or a control group(n=45).Both groups received guideline-directed lipid-lowering therapy;in addition.the observation group was treated with evolocumab injection.Both groups received regular treatment for 6 months.Lipid profiles.vulnerable carotid plaque–related indices.and adverse events were compared between the two groups before and after treatment.Results After treatment.levels of low-density lipoprotein cholesterol(LDL-C).total cholesterol(TC).and high-sensitivity C-reactive protein(hs-CRP)decreased in both groups compared with those before treatment;these levels were lower in the observation group than in the control group.and the differences were statistically significant(P<0.05).Triglyceride(TG)levels decreased in the observation group after treatment and were lower than those in the control group at the same time point.with statistically significant differences(P<0.05).There were no statistically significant differences in high-density lipoprotein cholesterol(HDL-C)levels within or between the two groups before and after treatment(P>0.05).The LDL-C goal attainment rate was higher in the observation group than in the control group.with a statistically significant difference(P<0.05).After treatment.carotid intima–media thickness(IMT).plaque area.and plaque thickness were significantly lower in both groups than those before treatment;these indices were lower in the observation group than in the control group.and the differences were statistically significant(P<0.05).There were no statistically significant differences in the number of plaques within or between the two groups before and after treatment(P>0.05).After treatment.the distribution of plaque types differed significantly between the two groups(P<0.05).The incidence of drug-related adverse reactions during treatment did not differ significantly between the two groups(P>0.05).Conclusion On the basis of conventional statin therapy.the addition of evolocumab can effectively reverse carotid atherosclerosis and improve the stability of vulnerable plaques.representing a potentially beneficial treatment strategy to reduce the risk of vulnerable carotid plaque rupture.
作者
冯源锡
李杏
秦娴
季晶晶
FENG Yuanxi;LI Xing;QIN Xian;JI Jingjing(Department of Cardiology,Wuxi Second People’s Hospital,Wuxi Jiangsu 214000,China;Department of Ultrasonography,Wuxi Second People’s Hospital,Wuxi Jiangsu 214000,China)
出处
《临床研究》
2026年第2期28-31,共4页
Clinical Research
基金
无锡市“双百”中青年医疗卫生拔尖人才(后备拔尖人才)培养计划(HB2023026)
无锡市卫生健康委项目(CXTDPY2021004)。
