阿利西尤单抗联合阿托伐他汀间歇治疗老年他汀不耐受脑梗死合并高脂血症患者的疗效分析

Therapeutic efficacy of alirocumab combined with intermittent atorvastatin in statin-intolerant elderly patients with cerebral infarction complicating hyperlipidemia

摘要:

目的 探讨阿利西尤单抗联合阿托伐他汀间歇治疗老年他汀不耐受脑梗死合并高脂血症患者的效果。方法 前瞻性选取2022年1月—2023年10月在江南大学附属医院和江南大学附属中心医院就诊的68例他汀不耐受脑梗死合并高脂血症患者，按随机数字表法分为研究组和对照组，每组34例。对照组给予阿托伐他汀间歇治疗，研究组在对照组基础上给予阿利西尤单抗，治疗4周观察效果。对比两组神经功能、血脂、临床疗效、血液黏度、斑块情况及药物不良反应情况。结果 研究组治疗前后美国国立卫生研究院卒中量表评分、改良Rankin量表评分、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血浆黏度、全血高切黏度、全血低切黏度、斑块大小、斑块厚度、斑块个数的差值均高于对照组（P <0.05）。研究组总有效率高于对照组（P <0.05）。两组总不良反应发生率比较，差异无统计学意义（P >0.05）。结论 阿利西尤单抗联合阿托伐他汀间歇治疗老年他汀不耐受脑梗死合并高脂血症患者疗效显著，可明显改善患者神经功能，调节血脂水平，降低血液黏度，改善斑块情况，安全可靠。

Abstract:

Objective To investigate the effect of alirocumab combined with intermittent atorvastatin in the treatment of cerebral infarction complicating hyperlipidemia among elderly patients with statin intolerance.Methods A total of 68 statin-intolerant patients with cerebral infarction complicating hyperlipidemia in Jiangnan University Affiliated Hospital and Jiangnan University Affiliated Central Hospital from January 2022 to October 2023 were prospectively selected and divided into the study group and the control group by the random number table method, with 34 cases in each group. The control group was treated with atorvastatin intermittently, and the study group was additionally treated with alirocumab. The effect was observed after 4 weeks of treatment. The neurological function, blood lipids, clinical efficacy, blood viscosity, plaque conditions and adverse drug reactions were compared between the two groups.Results The differences of the National Institutes of Health Stroke Scale scores, Modified Rankin Scale scores, levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, plasma viscosity, whole blood viscosity at high shear rates, whole blood viscosity at low shear rates, and the size, thickness and number of plaques before and after the treatment in the study group were all higher than those in the control group (P < 0.05). The overall effective rate of the study group was higher than that of the control group (P < 0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion Alirocumab combined with intermittent atorvastatin is significantly effective in the treatment of statin-intolerant elderly patients with cerebral infarction complicating hyperlipidemia. It remarkably improves the neurological function of patients, regulates blood lipid levels, and reduces blood viscosity and plaques safely and reliably.