牡丹江医科大学学报

目的 探究依洛尤单抗对冠心病患者炎症因子及短期预后的影响。方法 选择江门市人民医院冠心病患者300例(均于2022年1月-2024年1月入组)为研究对象，依据随机数字表法分组，均开展冠心病二级预防治疗，对照组(n=150)采用阿托伐他汀，实验组(n=150)给予阿托伐他汀+依洛尤单抗，均随访半年，比较两组治疗结局。结果 实验组用药3个月时总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白A[Lp(a)]、白介素-6(IL-6)低于对照组，且LDLC达标率高于对照组(P<0.05)。经Kaplan-Meier生存分析显示，两组患者不良事件发生情况比较差异有统计学意义(χ²=7.160,P=0.007)。同时，经二元logistic回归模型显示，应用依洛尤单抗、LDL-C达标、IL-6降低是影响患者不良事件发生情况的独立保护因素(P<0.05)。结论 依洛尤单抗通过降低血脂，尤其LDL-C改善预后，同时，可能存在通过改善患者炎症程度以改善预后。

Objective To investigate the effects of evolocumab on inflammatory markers and short-term prognosis in patients with coronary artery disease(CAD). Methods 300 CAD patients admitted to our hospital between January 2022 and January 2024 were enrolled. All patients received standard secondary prevention for coronary artery disease,and were randomly assigned to receive either atorvastatin alone(control group,n = 150) or atorvastatin plus evolocumab(experimental group,n = 150). All participants were followed for six months. Comparative analyses of treatment outcomes were performed.Results After three months of treatment,the experimental group exhibited lower total cholesterol(TC),triglycerides(TG),low-density-lipoprotein cholesterol(LDL-C),lipoprotein(a) [Lp(a) ] and interleukin-6(IL-6) than the control group,together with a higher LDL-C goal-achievement rate(P<0.05).Kaplan – Meier analysis showed a significant difference in adverse-event incidence between the two groups(χ²= 7.160,P = 0.007).Binary logistic regression analysis showed that evolocumab administration,achievement of the LDL-C target,and reduction in IL-6 were independent protective factors against the occurrence of adverse events in patients.(P<0.05).Conclusion Evolocumab improves prognosis primarily by lowering lipid levels,particularly LDL-C. Additionally,it may exert a prognostic benefit through mitigating the inflammatory status in patients..