目的 探討脂降寧片聯(lián)合依洛尤單抗治療他汀不耐受高脂血癥的臨床療效。方法 選取2021年7月-2023年7月大連大學(xué)附屬中山醫(yī)院收治的他汀不耐受高脂血癥患者124例。依據(jù)用藥情況分為對(duì)照組(62例)和治療組(62例)。對(duì)照組患者皮下注射依洛尤單抗注射液,140 mg/次,1次/15 d;在對(duì)照組基礎(chǔ)上,治療組口服脂降寧片,4片/次,3次/d;兩組患者治療8周。觀察兩組患者臨床療效,比較治療前后兩組患者緩解癥狀時(shí)間,血清總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、內(nèi)皮素-1(ET-1)、白細(xì)胞介素-6(IL-6)、P-選擇素(P-selectin)和腫瘤壞死因子-α(TNF-α)水平。結(jié)果 治療后,治療組臨床總有效率為95.16%,明顯高于對(duì)照組(83.87%,P<0.05)。治療后,治療組癥狀好轉(zhuǎn)時(shí)間均明顯早于對(duì)照組(P<0.05)。治療后,兩組患者TC、TG、LDL-C水平比治療前明顯降低,而HDL-C明顯升高(P<0.05),且治療組血脂水平明顯好于對(duì)照組(P<0.05)。治療后,兩組患者血清ET-1、IL-6、P-選擇素、TNF-α水平明顯降低(P<0.05),且治療組患者明顯低于對(duì)照組(P<0.05)。結(jié)論 依洛尤單抗與脂降寧片協(xié)同治療,有效改善高血脂患者癥狀,較好調(diào)節(jié)內(nèi)血脂含量,降低體內(nèi)炎性反應(yīng)。

Objective To explore the clinical effect of Zhijiangning Tablets combined with evolocumab in treatment of statin intolerance hyperlipidemia. Methods Patients (124 cases) with statin intolerance hyperlipidemia in Affiliated Zhongshan Hospital Dalian University from July 2021 to July 2023 were randomly divided into control (62 cases) and treatment (62 cases) group. Patients in the control group were hypodermic injection administered with Evolocumab Injection, 140 mg/time, once every 15 d. Patients in the treatment group were po administered with Zhijiangning Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, the symptom relief time, and the levels of serum TC, TG, LDL-C, HDL-C, ET-1, IL-6, P-selectin and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.16%, which was significantly higher than that of the control group (83.87%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the levels of TC, TG and LDL-C in two groups were significantly lower than those before treatment, while HDL-C was significantly increased (P < 0.05), and the blood lipid level in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the serum levels of ET-1, IL-6, P-selectin and TNF-α were significantly decreased in two groups, which in the treatment group were significantly lower than that in the control group (P < 0.05). Conclusion The synergistic treatment of Evolocumab Injection and Zhijiangning Tablets can effectively improve the symptoms of patients with hyperlipidemia, better regulate the content of blood lipids and reduce the inflammatory reaction in vivo.

R973

大連市中醫(yī)藥科學(xué)研究計(jì)劃項(xiàng)目（22Z11002）