|
|
|
| Clinical Study of Evolocumab Combined with Dapagliflozin in the Treatment of Patients with Atherosclerosis |
| ZHAO Guisheng, YANG Weiya |
| Fuyang County People's Hospital, Yancheng Jiangsu 224401 |
|
|
|
|
Abstract 【Objective】 To investigate the effects of evolocumab combined with standardized conventional treatment or dapagliflozin on plaque burden and stability, lipid levels, and the incidence of major adverse cardiovascular events (MACE) in patients with atherosclerosis and concomitant diabetes. 【Methods】 A total of 124 patients with atherosclerosis complicated by diabetes, who were admitted to our hospital from January 2023 to April 2025, were selected and randomly divided into two groups, with 62 cases in each group. Patients in both groups received standardized basic treatment. Additionally, the control group was treated with dapagliflozin, while the observation group was subcutaneously injected with evolocumab. The changes in target vessel plaque volume, low-attenuation plaque volume and unstable plaque ratio were evaluated. Laboratory indicators related to blood lipids and blood glucose [low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), total cholesterol (TC), triglycerides (TG)] were detected. The occurrence of major adverse cardiovascular events (MACE) and medication-related adverse reactions were recorded. All those parameters were compared between the two groups. 【Results】 After 6 months of treatment, the total plaque volume, low-attenuation plaque volume and unstable plaque ratio in both groups were lower than those before treatment; furthermore, these values were lower in the observation group than the control group. The differences were statistically significant (P<0.05). Following treatment, levels of LDL-C, non-HDL-C, total cholesterol and triglycerides in both groups were lower than those before treatment; and these levels in the observation group were lower than in the control group (P<0.05). For HDL-C, neither inter-group nor intra-group comparisons revealed statistically significant differences (P>0.05). The incidence of MACE in the observation group was lower than that in the control group, a difference that was statistically significant (P<0.05). There was no statistically significant difference in the incidence of adverse events between the two groups (P>0.05). 【Conclusion】 On the basis of standardized treatment and dapagliflozin, the addition of evolocumab can reduce LDL-C and non-HDL-C, achieve significant regression of atherosclerotic plaques and improve plaque stability with safety, thereby reducing the risk of MACE such as ischemic cerebrovascular events.
|
|
Received: 11 December 2025
|
|
|
|
|
|
[1] 陈伟明,朱志栋,王逸明,等.英克司兰与依洛尤单抗联合他汀类药物对超高危动脉粥样硬化性心血管病患者的降脂疗效比较[J].中国临床药学杂志,2025,34(1):45-50.
[2] 张辉,王利.依洛尤单抗在超高危动脉粥样硬化性心血管疾病患者中的疗效观察[J].实用药物与临床,2023,26(5):417-421.
[3] 张聪,徐丽斯,郑海洋,等.依洛尤单抗联合瑞舒伐他汀治疗老年超高危动脉粥样硬化性心血管疾病患者临床疗效[J].临床军医杂志,2023,51(11):1129-1132.
[4] 秦敬莉,王雷,马运聪,等.达格列净联合左西孟旦治疗慢性心力衰竭患者伴心律失常的疗效及安全性分析[J].中国现代医学杂志,2024,34(6):92-96.
[5] 中华心血管病杂志(网络版)编辑委员会. 动脉粥样硬化斑块的筛查与临床管理专家共识[J].中华心血管病杂志(网络版),2022,5(1):1-13.
[6] 蒋琳芝,李雷,杨丹丹,等.依洛尤单抗对不同载脂蛋白E基因型动脉硬化性心血管疾病患者血脂的影响[J].中国新药与临床杂志,2023,42(10):659-663.
[7] 路怀志,赵辉,王勇,等.前蛋白转化酶枯草溶菌素9抑制剂作为一级预防治疗对兔动脉粥样硬化斑块发生与进展的影响[J].中国医药,2024,19(8):1137-1141.
[8] 吴亚欣,孙雅轩.PCSK9抑制剂在颅内动脉粥样硬化性狭窄中应用的研究进展[J].中风与神经疾病杂志,2025,42(7):664-668.
[9] 王涛,刘惠芳,陈晓华.急性大动脉粥样硬化型脑梗死早期神经功能恶化的影响因素[J].医学临床研究,2023,40(11):1653-1655.
[10] 李景莎,丁超,汝磊生,等.依洛尤单抗对支架内再狭窄患者快速降脂及对不同人群的临床疗效分析[J].中国循证心血管医学杂志,2025,17(9):1064-1067.
[11] 倪占玲,刘洋,李轶.依洛尤单抗对急性冠脉综合征患者血浆抵抗素水平的影响[J].中国循证心血管医学杂志,2025,17(8):972-976.
[12] 石叶军,荆玉雷,李超生,等.依洛尤单抗与阿利西尤单抗对缺血性脑卒中的预防作用及用药安全性的Meta分析[J].中华神经医学杂志,2023,22(7):673-682.
[13] 张丽华,李为民,姚朱华,等.依洛尤单抗在动脉粥样硬化性心血管疾病患者中的临床获益:基于FOURIER研究中国亚组的探索[J].中国循环杂志,2023,38(7):704-710.
[14] 樊小玲,高岚.MRI、MSCT评估后循环缺血患者颅内IVBA斑块特征、形态改变与病情程度的相关性[J].医学临床研究,2025,42(1):78-81. |
| [1] |
. [J]. JOURNAL OF CLINICAL RESEARCH, 2026, 43(3): 521-523. |
|
|
|
|
2026, Vol. 43 
