目的 探讨脂降宁片联合依洛尤单抗治疗他汀不耐受高脂血症的临床疗效。方法 选取2021年7月-2023年7月大连大学附属中山医院收治的他汀不耐受高脂血症患者124例。依据用药情况分为对照组(62例)和治疗组(62例)。对照组患者皮下注射依洛尤单抗注射液,140 mg/次,1次/15 d;在对照组基础上,治疗组口服脂降宁片,4片/次,3次/d;两组患者治疗8周。观察两组患者临床疗效,比较治疗前后两组患者缓解症状时间,血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、内皮素-1(ET-1)、白细胞介素-6(IL-6)、P-选择素(P-selectin)和肿瘤坏死因子-α(TNF-α)水平。结果 治疗后,治疗组临床总有效率为95.16%,明显高于对照组(83.87%,P<0.05)。治疗后,治疗组症状好转时间均明显早于对照组(P<0.05)。治疗后,两组患者TC、TG、LDL-C水平比治疗前明显降低,而HDL-C明显升高(P<0.05),且治疗组血脂水平明显好于对照组(P<0.05)。治疗后,两组患者血清ET-1、IL-6、P-选择素、TNF-α水平明显降低(P<0.05),且治疗组患者明显低于对照组(P<0.05)。结论 依洛尤单抗与脂降宁片协同治疗,有效改善高血脂患者症状,较好调节内血脂含量,降低体内炎性反应。

Objective To explore the clinical effect of Zhijiangning Tablets combined with evolocumab in treatment of statin intolerance hyperlipidemia. Methods Patients (124 cases) with statin intolerance hyperlipidemia in Affiliated Zhongshan Hospital Dalian University from July 2021 to July 2023 were randomly divided into control (62 cases) and treatment (62 cases) group. Patients in the control group were hypodermic injection administered with Evolocumab Injection, 140 mg/time, once every 15 d. Patients in the treatment group were po administered with Zhijiangning Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, the symptom relief time, and the levels of serum TC, TG, LDL-C, HDL-C, ET-1, IL-6, P-selectin and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.16%, which was significantly higher than that of the control group (83.87%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the levels of TC, TG and LDL-C in two groups were significantly lower than those before treatment, while HDL-C was significantly increased (P < 0.05), and the blood lipid level in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the serum levels of ET-1, IL-6, P-selectin and TNF-α were significantly decreased in two groups, which in the treatment group were significantly lower than that in the control group (P < 0.05). Conclusion The synergistic treatment of Evolocumab Injection and Zhijiangning Tablets can effectively improve the symptoms of patients with hyperlipidemia, better regulate the content of blood lipids and reduce the inflammatory reaction in vivo.

R973

大连市中医药科学研究计划项目（22Z11002）