依洛尤单抗联合依折麦布治疗老年冠心病合并高脂血症患者的疗效及对血脂水平的影响

doi:10.3969/j.issn.1671-7171.2026.07.013

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摘要 【目的】探讨依洛尤单抗联合依折麦布在老年冠心病合并高脂血症患者的疗效及对血脂水平的影响。【方法】选择2023年3月至2024年2月本院收治的152例老年冠心病合并高脂血症患者,采用随机数字表法将患者分为观察组和对照组,每组76例。对照组在常规治疗的基础上联合依折麦布治疗,观察组在对照组的基础上联合依洛尤单抗治疗。比较两组的临床疗效、颈动脉超声指标、不良反应发生率及实验室指标[低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、可溶性细胞间黏附因子(sICAM-1)、N末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)、降钙素原(PCT)]。【结果】治疗后,观察组总有效率为97.37%(74/76),高于对照组的88.16%(67/76),差异有统计学意义(P<0.05)。治疗后,两组患者的血清LDL-C、TC、TG、sICAM-1、NT-proBNP、Hcy、PCT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者颈动脉内膜中层厚度、斑块面积小于治疗前,斑块个数少于治疗前,且观察组颈动脉内膜中层厚度、斑块面积小于对照组,斑块个数少于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】依洛尤单抗联合依折麦布治疗老年冠心病合并高脂血症患者,有助于降低血脂水平,改善血管内皮功能及心功能,且安全性良好。

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	汤恩铭
	陶乐维
	陈文哲

关键词 ：冠心病, 高脂血症, 抗体,单克隆, 依折麦布

Abstract：【Objective】 To investigate the clinical efficacy of evolocumab and ezetimibe and their influences on blood lipid levels in elderly patients with coronary heart disease (CHD) combined with hyperlipidemia. 【Methods】 A total of 152 elderly patients with CHD and hyperlipidemia admitted to our hospital from March 2023 to February 2024 were enrolled and divided into observation group and control group by random number table, with 76 cases in each group. The control group received ezetimibe on the basis of routine treatment, while the observation group was additionally given evolocumab combined with ezetimibe. The clinical efficacy, carotid ultrasound indicators, incidence of adverse reactions and laboratory parameters including low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), soluble intercellular adhesion molecule-1 (sICAM-1), N-terminal pro-brain natriuretic peptide (NT-proBNP) and homocysteine (Hcy), procalcitonin (PCT) were compared between the two groups. 【Results】 After treatment, the total effective rate of the observation group was 97.37% (74/76), which was higher than 88.16% (67/76) of the control group (P<0.05). The serum levels of LDL-C, TC, TG, sICAM-1, NT-proBNP, Hcy and PCT in both groups decreased after treatment, and the observation group showed significantly lower levels than the control group (P<0.05). Carotid intima-media thickness and plaque area were reduced, and the number of plaques decreased in both groups after treatment; the observation group had thinner intima-media thickness, smaller plaque area and fewer plaques compared with the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusions】 Combined therapy of evolocumab and ezetimibe can effectively reduce blood lipid levels, improve vascular endothelial and cardiac function with favorable safety profile in elderly patients with coronary heart disease complicated with hyperlipidemia.

Key words： Coronary Heart Disease Hyperlipidemias Antibodies,Monoclonal Ezetimibe

收稿日期: 2025-04-22

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R541.4

引用本文:

汤恩铭, 陶乐维, 陈文哲. 依洛尤单抗联合依折麦布治疗老年冠心病合并高脂血症患者的疗效及对血脂水平的影响[J]. 医学临床研究, 2026, 43(7): 1101-1104.
TANG Enming, TAO Lewei, CHEN Wenzhe. Efficacy of Evolocumab Versus Ezetimibe in the Treatment of Elderly Patients with Coronary Heart Disease Complicated with Hyperlipidemia. JOURNAL OF CLINICAL RESEARCH, 2026, 43(7): 1101-1104.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.07.013 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I7/1101

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