中风与神经疾病杂志2024，Vol.41Issue(4)：349-354,6.DOI:10.19845/j.cnki.zfysjjbzz.2024.0068
PCSK9抑制剂联合阿托伐他汀对颅内动脉粥样硬化性狭窄的治疗效果
Clinical effect of proprotein convertase subtilisin/kexin type 9 inhibitor combined with atorvastatin in treatment of intracranial atherosclerotic stenosis
摘要
Abstract
Objective To investigate the effect of proprotein convertase subtilisin/kexin type 9 inhibitor(PCSK9)combined with atorvastatin on intracranial plaque in patients with intracranial atherosclerotic stenosis(ICAS).Methods A prospective study was performed for the imaging and clinical data of ICAS patients who were admitted to Tianjin Beichen Hos-pital from January 2022 to April 2023 and received atorvastatin with or without PCSK9 inhibitor.The patients in the atorvas-tatin group received treatment with atorvastatin 10-40 mg per day,once a day,and those in the PCSK9 inhibitor group re-ceived 140 mg evolocumab injection,once every two weeks,in addition to the treatment in the atorvastatin group.The two groups were compared in terms of HR-MRI imaging findings and blood lipid levels before treatment and after 12 weeks of treatment,as well as major vascular events and adverse drug reactions during treatment.Results A total of 98 patients were enrolled,with 46 in the atorvastatin group and 52 in the PCSK9 inhibitor group.There were no significant differences in blood lipid levels and HR-MRI parameters between the two groups at baseline.From baseline to after 12 weeks of treatment,the PCSK9 inhibitor group had significant reductions in the levels of total cholesterol(TC),triglyceride,and low-density li-poprotein(LDL)(all P<0.001),while the atorvastatin group only had significant reductions in the levels of TC and LDL(both P<0.001),and the PCSK9 inhibitor group had significantly lower levels of TC and LDL than the atorvastatin group(both P<0.001).From baseline to after 12 weeks of treatment,the PCSK9 inhibitor group had significant reductions in arte-rial stenosis rate and standardized wall index(both P=0.001),while the atorvastatin group had no significant changes in HR-MRI parameters(all P>0.05).After 12 weeks of treatment,the PCSK9 inhibitor group had a significantly higher proportion of patients with good treatment response than the atorvastatin group(75.00%vs 45.65%,χ2=8.885,P=0.003).Conclusion The combination of PCSK9 inhibitor and atorvastatin can not only reduce level of LDL in ICAS patients,but also reduce the degree of stenosis,with relatively high safety.关键词
PCSK9抑制剂/他汀类药物/颅内动脉粥样硬化/高分辨率MRIKey words
PCSK9 inhibitor/Statins/Intracranial atherosclerosis/High-resolution MRI分类
医药卫生引用本文复制引用
胡群亮,田竺,张盛蕊,吴焕成..PCSK9抑制剂联合阿托伐他汀对颅内动脉粥样硬化性狭窄的治疗效果[J].中风与神经疾病杂志,2024,41(4):349-354,6.基金项目
天津北辰科技计划项目(SHGY-2020008) （SHGY-2020008）
