【摘要】 目的：探讨采用强化剂量瑞舒伐他汀联合依洛尤单抗方案对急性心肌梗死（AMI）经皮冠脉介入术（PCI）术后应用的效果，并分析其对冠状动脉解剖复杂程度评分（SYNTAX评分）及临床结局的影响。方法：纳入2022年1月～2024年1月在某院接受PCI治疗的AMI患者106例作为研究对象。采用随机数字表法分为观察组和对照组，每组53例。对照组给予常规剂量瑞舒伐他汀（10 mg/d）联合依洛尤单抗方案，观察组给予强化剂量瑞舒伐他汀（20 mg/d）联合依洛尤单抗方案，对入组患者随访10个月，观察临床效果。结果：治疗后，两组患者低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比率（PLR）、SYNTAX评分及冠脉微血管血流帧数均下降（P<0.05），且观察组低于对照组（P<0.05）；两组左室整体纵向应变、整体做功效率、整体有用功均升高（P<0.05），且观察组高于对照组（P<0.05）。观察组用药后不良反应总发生率（7.55%）低于对照组（22.64%,P<0.05）。Logistic回归分析显示，治疗后LDL-C、NLR水平是患者发生不良事件的危险因素（P<0.05）。结论：强化剂量瑞舒伐他汀联合依洛尤单抗方案可以更有效地改善AMI患者PCI术后脂代谢、炎症、冠脉循环及左室重构，降低术后不良事件风险。更多还原

【Abstract】 Objective: To explore the efficacy of intensive-dose rosuvastatin combined with evolocumab in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI), and to analyze its impact on synergy between pci with taxus and cardiac surgery score(SYNTAX score) and clinical outcomes. Methods: A total of 106 AMI patients who underwent PCI in our hospital from January 2022 to January 2024 were enrolled and randomly divided into the observation group(n=53) and control group(n=53) using a random number table. The control group received conventional-dose rosuvastatin(10 mg/d) combined with evolocumab, while the observation group received intensive-dose rosuvastatin(20 mg/d) combined with evolocumab. All patients were followed up for 10 months to evaluate the clinical effects. Results: After treatment,levels of low-density lipoprotein cholesterol(LDL-C), triglycerides, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), SYNTAX score, and coronary microvascular flow frame count significantly decreased in both groups(all P<0.05), with more pronounced reductions in the observation group(all P<0.05). Left ventricular global longitudinal strain, global work efficiency,and global useful work were significantly increased in both groups(all P<0.05), and the observation group exhibited higher values(all P<0.05). The total incidence of adverse reactions was lower in the observation group(7.55%) than in the control group(22.64%, P<0.05). Logistic regression analysis revealed that post-treatment LDL-C and NLR levels were independent risk factors for adverse events(all P<0.05). Conclusion: Intensive-dose rosuvastatin combined with evolocumab can more effectively improve lipid metabolism, inflammatory status, coronary circulation, and left ventricular remodeling in AMI patients after PCI, and reduce the risk of postoperative adverse events.更多还原