Abstract：
Limited data have been reported on the use of proprotein convertase subtilisin/kexin type 9 (PCSK 9) inhibitors during pregnancy in women with familial hypercholesterolemia (FH). Here, we present the first case of initiating evolocumab (PCSK9 inhibitor) in a compound heterozygous FH mother. The patient was a 34-year-old primipara with severe dyslipidemia and a history of coronary artery bypass surgery. An elevated low-density lipoprotein cholesterol (LDL-C) level of 420 mg/dL was detected in the first trimester and persistently increased throughout pregnancy. Evolocumab was administered at 31 and 35 weeks of gestation, showing a positive effect on stabilizing LDL-C levels. Planned delivery with labor analgesia was performed at 38 + 4 weeks. Both the mother and infant were discharged without any notable complications. Hence, evolocumab, an IgG2 monochromatic antibody with little placental permeability, may be an alternative medication with limited influence on infants. Further studies are needed to assess the safety of evolocumab administration during pregnancy.
摘要：
关于家族性高胆固醇血症（FH）妇女在怀孕期间使用前蛋白转化酶枯草杆菌蛋白酶/kexin9型（PCSK9）抑制剂的报道有限。这里,我们介绍了在复合杂合子FH母亲中启动evolocumab(PCSK9抑制剂)的首例病例.该患者是一名34岁的初产妇，患有严重的血脂异常和冠状动脉搭桥手术史。在孕早期检测到低密度脂蛋白胆固醇（LDL-C）水平升高为420mg/dL，并在整个怀孕期间持续升高。Evolocumab在妊娠31周和35周时给药，显示对稳定LDL-C水平的积极作用。计划分娩38+4周进行分娩镇痛。母婴均出院，无明显并发症。因此，evolocumab,一种胎盘通透性小的IgG2单色抗体，可能是对婴儿影响有限的替代药物。需要进一步的研究来评估怀孕期间evolocumab给药的安全性。
