目的:评估低剂量阿托伐他汀钙联合evolocumab对补体调节蛋白水平的影响,脂质分布,冠心病(CHD)患者的心功能。
方法:进行前瞻性随机对照研究,180名来自广安门医院的冠心病患者,中国中医科学院,和山西医科大学第二医院,2022年2月至2023年4月。这些患者被随机分配到对照组(n=90),接受低剂量阿托伐他汀钙,或研究组(n=90),接受低剂量阿托伐他汀钙和evolocumab的联合治疗。心功能指标的变化,血脂和补体蛋白的水平,副作用的发生率,比较两组患者的心血管事件。
结果:治疗后,两组均显示血脂水平降低.然而,研究组的总胆固醇(TC)水平显着降低,甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C)与对照组比较(均P<0.001)。此外,两组患者的心功能指标均有改善,研究小组显示心输出量(CO)有更大的增强,每搏输出量(SV),左心室射血分数(LVEF)。此外,补体调节蛋白的水平,包括CD45,CD46,CD55和CD59,在治疗后两组都增加,研究组表现出明显更高的水平(所有P<0.001)。值得注意的是,研究组的心血管事件发生率也较低.
结论:联合使用低剂量阿托伐他汀钙和evolocumab可有效调节补体调节蛋白水平,优化血脂分布,并增强冠心病患者的心功能。这种联合疗法代表了治疗CHD的一种有希望的方法。
OBJECTIVE: To assess the effects of combining low-dose atorvastatin calcium with
evolocumab on complement regulatory protein levels, lipid profiles, and cardiac function in patients with coronary heart disease (CHD).
METHODS: A prospective randomized controlled study was conducted, with 180 CHD patients enrolled from Guang\'anmen Hospital, China Academy of Chinese Medical Sciences, and the Second Hospital of Shanxi Medical University between February 2022 and April 2023. These patients were randomly assigned to either the control group (n = 90), receiving low-dose atorvastatin calcium, or the research group (n = 90), receiving a combination of low-dose atorvastatin calcium and
evolocumab. The changes in cardiac function indices, levels of blood lipids and complement proteins, incidence of side effects, and cardiovascular events were compared between the two groups.
RESULTS: After treatment, both groups exhibited reductions in blood lipid levels. However, the research group demonstrated significantly lower levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) compared to the control group (all P < 0.001). Additionally, improvements in cardiac function indices were observed in both groups, with the research group displaying greater enhancements in cardiac output (CO), stroke volume (SV), and left ventricular ejection fraction (LVEF). Furthermore, the levels of complement regulatory proteins, including CD45, CD46, CD55, and CD59, increased in both groups after treatment, with the research group exhibiting significantly higher levels (all P < 0.001). Notably, the research group also exhibited a lower incidence of cardiovascular events.
CONCLUSIONS: The combined use of low-dose atorvastatin calcium and
evolocumab effectively modulates complement regulatory protein levels, optimizes blood lipid profiles, and enhances cardiac function in patients with CHD. This combination therapy represents a promising approach for management of CHD.