药物球囊联合PCSK-9抑制剂在冠脉小血管病变中短期疗效观察

Analysis of the Curative Effect of Drug-Coated Balloon and PCSK-9 Inhibitors in Small Coronary Vessels

摘要: 目的：分析药物涂层球囊(DCB)联合依洛尤单抗(PCSK-9抑制剂)在冠状动脉小血管病变的疗效评价。方法：连续入选2021年2月至2022年2月我院冠心病小血管病变患者130例，随机分为对照组、观察组，分别采用药物球囊、药物球囊联合依洛尤单抗治疗，6个月后比较两组血脂水平、LDL-C达标率、主要不良心血管事件(MACE)发生率、西雅图心绞痛量表(SAQ)评分[包括心绞痛平稳状况(AS)、心绞痛发生状况(AF)、躯体运动受限情况(PL)、医疗满意度(TS)和病情认知能力(DP)]；结果：治疗6个月后两组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白-a (Lp(a))水平均低于治疗前(P < 0.05)。且观察组TC、LDL-C、Lp(a)水平均明显低于对照组(P < 0.05)；对照组LDL-C的达标率仅为30.7%，而观察组LDL-C的达标率高达91%；两组患者AS、AF、PL、DP、TS均高于治疗前(P < 0.05)，观察组治疗后AS、AF、PL、TS水平均明显高于对照组(P < 0.05)，但MACE发生率无差异。结论：药物球囊联合依洛尤单抗治疗冠脉小血管病变，可使患者LDL-C水平下降，LDL-C达标率较高，同时可缓解冠状动脉小血管病变患者心绞痛症状，应用前景良好。

Abstract: Objective: To evaluate the efficacy of drug coated balloon (DCB) combined with elolumab (PCSK-9 inhibitor), in the treatment of small coronary vessels lesions. Methods: 130 patients with small coronary vessels in our hospital from February 2021 to February 2022 were selected and randomly divided into Control group and Study group. Patients in the two groups were treated with DCB, and DCB combined with elolumab respectively. Six months later, efficacy was performed to compare the incidence of the blood lipid level, LDL-C compliance rate, incidence of major adverse cardiovascular events (MACE), and Seattle angina scale (SAQ) score [including angina stable condition (AS), angina occurrence (AF), physical motor limitations (PL), medical satisfaction (TS) and condition cognitive ability (DP)] between the two groups. Results: Six months later, the difference values of cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and lipoprotein-a (Lp(a)) before and after treatment in observation group were greater than those in control group (P < 0.05). The compliance rate of LDL-C in the control group was only 30.7%, while that of LDL-C in the study group was as high as 91%. The difference values of AS, AF, PL, DP and TS before and after treatment in ob-servation group were greater than those in control group (P < 0.05), but there was no difference of MACE in two groups. Conclusion: The treatment of coronary small vessel lesions with drug balloon combined with elocumumab can reduce LDL-C level and achieve high LDL-C compliance rate, and can relieve angina symptoms, with high application prospect.