黑龙江医药

目的:探讨依洛尤单抗和阿利西尤单抗治疗动脉粥样硬化性心血管疾病(ASCVD)高危、极高危患者的临床效果，为顺德地区个体化降脂治疗提供依据。方法:回顾性分析2023年1月至8月顺德地区80例ASCVD高危、极高危患者的临床资料，依据治疗药物的不同将其分为A组(40例)和B组(40例)。A组采用依洛尤单抗治疗，B组采用阿利西尤单抗治疗。对比两组血脂指标、不良心血管事件及药物不良反应。结果:两组治疗后总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)均较治疗前降低，高密度脂蛋白胆固醇(HDL-C)较治疗前升高，且B组的TC、LDL-C、TG低于A组，HDL-C高于A组(P<0.05);两组患者不良心血管事件发生率比较，无统计学差异(P>0.05);两组均未出现明显药物相关不良反应。结论:依洛尤单抗与阿利西尤单抗用于顺德地区ASCVD高危、极高危患者治疗，均能有效改善血脂，而阿利西尤单抗的血脂调节效果更优，可为区域内临床医生选择更适配的PCSK9i药物提供参考，提升ASCVD高危、极高危患者的血脂管理质量，进而降低远期心血管事件风险。

Objective: To investigate the clinical effects of Evolocumab and Alirocumab in high-risk and very-high-risk patients with atherosclerotic cardiovascular disease(ASCVD), providing evidence for personalized lipid-lowering therapy in the Shunde region. Methods: A retrospective analysis was conducted on the clinical data of 80 high-risk and very-high-risk ASCVD patients in the Shunde region from January to August 2023. Based on the different medications used, the patients were divided into Group A(40 cases) and Group B(40 cases). Group A received Evolocumab, while Group B received Alirocumab. Lipid parameters, adverse cardiovascular events, and drug-related adverse reactions were compared between the two groups. Results: After treatment, total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), and triglycerides(TG) decreased in both groups compared to pre-treatment levels, while high-density lipoprotein cholesterol(HDL-C) increased. Group B showed lower TC, LDL-C, and TG levels and higher HDL-C levels than Group A(P<0.05). There was no statistically significant difference in the incidence of adverse cardiovascular events between the two groups(P>0.05). Neither group exhibited significant drug-related adverse reactions. Conclusion: Both evolocumab and alirocumab effectively improve lipid profiles in high-risk and very-high-risk ASCVD patients in the Shunde region, with alirocumab demonstrating superior lipid-modulating efficacy. This finding provides a reference for clinicians in the region to select the more suitable PCSK9 inhibitor, thereby enhancing the quality of lipid management in high-risk and very-high-risk ASCVD patients and ultimately reducing the risk of long-term cardiovascular events.