中国动脉硬化杂志2026，Vol.34Issue(7)：679-685,7.DOI:10.20039/j.cnki.1007-3949.2026.07.010
PCSK9抑制剂对老年糖尿病合并急性冠脉综合征患者PCI术后远期预后的影响
Effects of PCSK9 inhibitors on long-term prognosis after PCI in elderly diabetic pa-tients complicated with acute coronary syndrome
摘要
Abstract
Aim To investigate the effects of proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors on the incidence of restenosis 1 year and major adverse cardiovascular and cerebrovascular events(MACCE)3 years after percutaneous coronary intervention(PCI)in elderly patients with diabetes and acute coronary syndrome(ACS).Methods 320 elderly patients with diabetes and ACS were randomly divided into the conventional treatment group and PCSK9 inhibitor group,with 160 cases in each group.The conventional treatment group received standardized drug treat-ment after PCI,while the PCSK9 inhibitor group received PCSK9 inhibitor in addition to standardized drug treatment for a course of 1 year.The total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDLC),low den-sity lipoprotein cholesterol(LDLC),lipoprotein(a),high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and other test indicators as well as the incidence of restenosis at PCI site were observed in the two groups of patients,and the primary endpoint(myocardial infarction,cardiac death,and all-cause death),the composite endpoint(myocardial infarction,cardiac death,ischemia-driven repeat revascularization,stent thrombosis,and stroke)of the secondary endpoint(MACCE)and the incidence of angina pectoris and hospital readmission were compara-tively analyzed through 3-year follow-up.Results After 1 year of treatment,the levels of TC,TG,LDLC,lipoprotein(a),hs-CRP,TNF-α,IL-6,and the incidence of restenosis in the PCSK9 inhibitor group were significantly lower than those in the conventional treatment group(P<0.05).The 3-year follow-up results showed that the primary endpoint events(car-diac death,myocardial infarction),total MACCE,stent thrombosis,angina recurrence,and repeat revascularization inci-dence in the PCSK9 inhibitor group were significantly lower than those in the conventional treatment group(P<0.05).Conclusion PCSK9 inhibitors can effectively reduce the blood lipid level,inhibit inflammatory reaction,and reduce the incidence of restenosis 1 year after PCI and MACCE 3 years after PCI in elderly patients with diabetes and ACS.关键词
糖尿病/急性冠脉综合征/经皮冠状动脉介入治疗/前蛋白转化酶枯草溶菌素 9/主要不良心脑血管事件/远期预后Key words
diabetes/acute coronary syndrome/percutaneous coronary intervention/proprotein convertase subtilisin/kexin type 9/main adverse cardiovascular and cerebrovascular events/long-term prognosis分类
医药卫生引用本文复制引用
刘洋,王子函,薛斌,陈奇,姬劲锐,魏小云,杨庆宇,刘恒亮..PCSK9抑制剂对老年糖尿病合并急性冠脉综合征患者PCI术后远期预后的影响[J].中国动脉硬化杂志,2026,34(7):679-685,7.基金项目
河南省科技发展计划项目(222102310345) （222102310345）
