【摘要】 目的 探讨超高危动脉粥样硬化性心血管病（ASCVD）患者应用依洛尤单抗联合依折麦布降脂治疗的临床价值。方法 纳入2021年10月—2023年9月临沂市人民医院收治的104例超高危ASCVD患者，根据治疗方案分为观察组和对照组，每组52例。所有患者均接受超高危ASCVD标准治疗方案，对照组给予依折麦布治疗，观察组在对照组基础上应用依洛尤单抗。两组均持续治疗4周。比较两组血脂指标、心肌损伤标志物、肌酐、肌酸激酶、不良反应及心脑血管事件发生情况。结果 治疗前，两组总胆固醇（TC）、丙三醇三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平比较，差异无统计学意义（P>0.05）；治疗后，两组TC、TG、LDL-C水平均低于治疗前，且观察组低于对照组，差异有统计学意义（P<0.05）。治疗前，两组心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶（CK-MB）水平比较，差异无统计学意义（P>0.05）；治疗后，两组cTnI、CK-MB水平均低于治疗前，且观察组低于对照组，差异有统计学意义（P<0.05）。治疗前后，两组肌酐、肌酸激酶水平比较，差异无统计学意义（P>0.05）。两组不良反应总发生率比较，差异无统计学意义（P>0.05）。观察组心脑血管事件总发生率低于对照组，差异有统计学意义（P<0.05）。结论 对超高危ASCVD患者，依洛尤单抗联合依折麦布治疗对降脂效果有一定的提升作用，可减少心脑血管事件的发生，且用药过程的安全性较好。更多还原

【Abstract】 Objective To explore the clinical value of lipid-lowering treatment with elumab combined with ezetimibe in patients with ultra-high-risk atherosclerotic cardiovascular disease(ASCVD). Methods A total of 104 patients with ultra-highrisk ASCVD in Linyi People’s Hospital from October 2021 to September 2023 were prospectively included. ·According to the treatment plan, patients were divided into an observation group and a control group, with 52 cases in each group. All patients received the standard treatment regimens related to ultra-high-risk ASCVD. The control group was treated with ezetimibe, while the observation group was treated with elumab on the basis of the control group. Both groups received continuous treatment for 4 weeks. The lipid indicators, myocardial injury markers, creatinine, creatine kinase, adverse reactions and the occurrence of cardiovascular and cerebrovascular events were compared between the two groups. Results Before treatment, there was no statistically significant difference in the levels of total cholesterol(TC), triglycerides(TG), and low-density lipoprotein cholesterol(LDL-C) between the two groups(P>0.05). After treatment, the levels of TC, TG and LDL-C in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group. The differences were statistically significant(P<0.05). Before treatment, there was no statistically significant difference in the levels of cardiac troponin I(cTnI) and creatine kinase isoenzyme(CK-MB) between the two groups(P>0.05). After treatment, the levels of cTnI and CK-MB in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group. The differences were statistically significant(P<0.05). Before and after treatment, there was no statistically significant difference in the levels of creatinine and creatine kinase between the two groups(P> 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05). The total incidence of cardiovascular and cerebrovascular events in the observation group was lower than that in the control group, and the difference was statistically significant(P <0.05). Conclusion For patients with ultra-high-risk ASCVD, the combined treatment of elumab and ezetimibe has a certain improvement effect on lipid-lowering, can reduce the occurrence of cardiovascular and cerebrovascular events, and the safety of the medication process is relatively good.更多还原