目的 探讨依洛尤单抗注射液联合普伐他汀治疗高脂血症的临床疗效。方法 纳入2020年6月—2024年6月北京卫戍区朝阳第三退休干部休养所和解放军总医院第九医学中心收治的82例高脂血症患者，按随机数字表法平均分为对照组和治疗组，每组各41例。对照组每晚顿服普伐他汀钠片，20 mg/次。在对照组基础上治疗组患者皮下注射依洛尤单抗注射液，140 mg/次，1次/2周。两组患者治疗4周。观察两组临床疗效，比较治疗前后两组患者症状改善时间，血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和三酰甘油（TG）水平，及血浆黏度（PV）、红细胞聚集指数（EAI）、红细胞比容（HCT）、中性粒细胞/淋巴细胞比值（NLR）、C反应蛋白（CRP）和可溶性血管细胞黏附分子-1（sVCAM-1）水平。结果 治疗后，治疗组总有效率明显高于对照组（95.12% vs 80.49%，P＜0.05）。治疗后，治疗组治疗后，治疗组头晕、头重如裹、乏力、胸闷、肢体沉重改善时间显著短于对照组（P＜0.05）。治疗后，两组血清TC、LDL-C、TG、sVCAM-1及PV、EAI、HCT和NLR、CRP水平均降低，血清HDL-C显著升高（P＜0.05），且治疗组这些指标变化均好于对照组（P＜0.05）。结论 应用依洛尤单抗注射液联合普伐他汀治疗高脂血症，安全性较佳，能有效控制血脂水平，促进血液流变学、机体炎症及症状改善。

Objective To investigate the clinical efficacy of Evolocumab Injection combined with pravastatin in treatment of hyperlipidemia. Methods Patients (82 cases) with hyperlipidemia in Chaoyang Third Retired Cadre Rest Center and the Ninth Medical Center of the People′s Liberation Army General Hospital from June 2020 to June 2024 were divided into control and treatment group according to the random number table method, and each group had 41 cases. Patients in the control group were po administered with Pravastatin Sodium Tablets every night, 20 mg/time, once daily. Patients in the treatment group were subcutaneous injection administered with Evolocumab Injection on the basis of the control group, 140 mg/time, once every two weeks. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the improvement time of symptoms, the levels of TC, LDL-C, TG and HDL-C, PV, EAI, HCT, NLR, CRP and sVCAM-1 in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (95.12% vs 80.49%, P < 0.05). After treatment, the improvement time for dizziness, a heavy head as if wrapped, fatigue, chest tightness and heavy limbs in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the serum TC, LDL-C, TG, sVCAM-1, PV, EAI, HCT, NLR, CRP levels were decreased in two groups, and serum HDL-C levels were significantly increased (P < 0.05), and the changes of these indicators in the treatment group were better than those in the control group (P < 0.05). Conclusion The combination of Evolocumab Injection and pravastatin is safe for the treatment of hyperlipidemia, and can effectively control blood lipid levels, promote blood rheology, inflammation, and symptom improvement.

R972

驻北京市老干部服务管理局医疗保健实用技术研究项目（2023ZJJ07）