早期应用依洛尤单抗对经皮冠状动脉介入术后的超高危动脉粥样硬化性心血管疾病患者发生心血管事件的影响
Effect of Early Use of Enwolocumab on Cardiovascular Events in Patients with Extremely-High-Risk Atherosclerotic Cardiovascular Disease after Percutaneouscoronary Intervention

目的：探讨PCI术后的超高危ASCVD患者术后早期应用依洛尤单抗对其发生主要心血管不良事件(MACE)的影响。方法：选取2021年1月至2022年1月于青岛大学附属医院急诊内科行PCI后符合超高危ASCVD诊断患者203例，术后7天内使用依洛尤单抗患者纳入观察组(102例)，未使用依洛尤单抗的患者纳入对照组(101例)，记录两组患者入院时基本信息、临床资料。分别在患者出院后1、3、6月对其进行随访，观察患者血脂等临床资料变化，记录患者MACE发生时间。结果：在1、3、6月随访时，观察组的TC、LDL-C、ApoB较对照组明显降低，差异均具有统计学意义(p < 0.01)，观察组LP(a)也较对照组降低，差异具有统计学意义(p < 0.05)。观察组与对照组相比，LDL-C达标率显著增高，差异具有统计学意义(p < 0.01)。观察组MACE发生率显著降低(10.78% vs. 21.78%)，差异具有统计学意义(p = 0.034)。结论：尽早使用依洛尤单抗能够显著提高PCI术后的超高危ASCVD患者LDL-C达标率，降低心血管事件发生风险。
Objective: To investigate the effect of early administration of envolocumab on major cardiovascular adverse events (MACE) in patients with high risk of ASCVD after PCI. Method: A total of 203 patients who were diagnosed with ultra-high risk ASCVD after PCI in the Emergency Department of Affiliated Hospital of Qingdao University from January 2021 to January 2022 were selected. Patients who re-ceived envolocumab within 7 days after surgery were included in the observation group (101 cas-es). Patients who did not use envolocumab were included in the control group (102 cases), and the basic information and clinical data of patients in both groups at admission were recorded. The pa-tients were followed up 1, 3 and 6 months after discharge, to observe the changes of blood lipid and other clinical data, and to record the occurrence time of MACE. Results: At 1, 3 and 6 months of fol-low-up, TC, LDL-C and ApoB in the observation group were significantly lower than those in the con-trol group, the differences were statistically significant (p < 0.01). LP (A) in the observation group was lower than that in the control group, the differences were statistically significant (p < 0.05). Compared with the control group, the observation group had a higher LDL-C compliance rate and a lower mean, the difference was statistically significant (p < 0.01), and the incidence of MACE events was lower than that of the control group (10.78% vs. 21.78%), the difference was statistically sig-nificant (p = 0.034). Conclusions: Early use of envolocumab can increase the blood lipid attainment rate in patients with high risk of ASCVD after PCI and reduce the risk of cardiovascular events.