摘要
目的:探究前蛋白转化酶枯草溶菌素9(PCSK9)抑制剂对急性ST段抬高性心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后心肌挽救指数(MSI)及左室重构的影响。方法:前瞻性入选2021年1月—2023年10月天津医科大学朱宪彝纪念医院60例行急诊PCI治疗的STEMI患者,随机分为PCSK9抑制剂组和对照组。两组患者PCI术前应用常规抗栓复合药物,术后继续冠心病二级预防药物及控制其他相关危险因素等常规治疗。对照组予阿托伐他汀治疗,PCSK9抑制剂组在对照组基础上加用依洛尤单抗注射液治疗。PCI术后5~7 d完善心脏磁共振,测量心肌危险区域(AAR)及心肌梗死面积(IS),计算MSI。3个月复查超声心动图评估左室重构指标:室间隔厚度(IVS)、左室后壁厚度(LVPW)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)。结果:PCSK9抑制剂组与对照组患者的AAR比较无显著性差异,PCSK9抑制剂组的IS小于对照组,MSI高于对照组,且差异有统计学意义(P<0.05)。3个月治疗后,PCSK9抑制剂组LVEDD低于对照组,两组患者的LVEF较前均升高,且PCSK9抑制剂组LVEF升高幅度高于对照组(P<0.05)。结论:PCSK9抑制剂可改善STEMI患者PCI术后MSI及左室重构。
Objective To investigate the effects of PCSK9 inhibitors on myocardial salvage index and left ventricular remodeling after percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Sixty STEMI patients undergoing emergency PCI treatment in Tianjin Medical University Zhu Xian Yi Memorial Hospital from January 2021 to October 2023 were prospectively enrolled and randomly divided into PCSK9 inhibitor group and control group.The two groups were treated with conventional antithrombotic compound drugs before PCI,and continued with secondary prevention drugs and control of other related risk factors after PCI.The control group was treated with atorvastatin,and the PCSK9 inhibitor group was treated with ilozumab injection.Cardiac MRI was performed 5-7 days after PCI,the area at risk(AAR)and myocardial infarct size(IS)were measured,and MSI was calculated.Echocardiography at 3 months to evaluate LVR indicators:Interventricular septal thickness(IVS),Left ventricular posterior wall thickness(LVPW),Left ventricular end-systolic diameter(LVESD),Left ventricular end-diastolic diameter(LVESD),left ventricular end-diastolic diameter(LVESD),left ventricular end-diastolic diameter,LVEDD,Left ventricular ejection fraction(LVEF).Results There was no significant difference in AAR between PCSK9 inhibitor group and control group.The IS and MSI of PCSK9 inhibitor group were lower than those of control group,and the difference was statistically significant(P<0.05).After 3 months of treatment,LVEDD in PCSK9 inhibitor group was lower than that in control group,LVEF in both groups was higher than before,and LVEF in PCSK9 inhibitor group was higher than that in control group(P<0.05).Conclusion PCSK9 inhibitors can improve MSI and LVR after PCI in STEMI patients.
作者
周庆娜
宋云萍
汤云昭
潘从清
ZHOU Qingna;SONG Yunping;TANG Yunzhao;PAN Congqing(Zhu Xian Yi Memorial Hospital,Tianjin Medical University,Tianjin Institute of Endocrinology,National Health Commission Key Laboratory of Hormone Development,Tianjin Key Laboratory of Metabolic Diseases,Tianjin,300400,China)
出处
《临床心血管病杂志》
CAS
2024年第6期457-461,共5页
Journal of Clinical Cardiology
基金
天津市医学重点学科(专科)建设项目(No:TJYXZDXK-032A)。
关键词
PCSK9抑制剂
急性心肌梗死
心肌挽救指数
心室重构
PCSK9 inhibitor
acute myocardial infarction
myocardial salvage index
ventricular remodeling
