阿利西尤单抗在老年他汀不耐受脑梗死合并高脂血症中的应用及对神经功能和预后的影响OA
Application of alirocumab in elderly patients with cerebral infarction complicated by hyperlipidemia intolerant to statins,and its impact on neurological function and prognosis
目的 探讨阿利西尤单抗联合神经介入治疗老年他汀不耐受脑梗死合并高脂血症的效果.方法 回顾性选取 2020 年 1 月—2024 年 8 月太原钢铁(集团)有限公司总医院神经内科诊治的老年他汀不耐受脑梗死合并高脂血症患者 86 例,按照治疗方案不同分为神经介入组及单抗+介入组,各 43 例.2 组均给予基础治疗,神经介入组另予神经介入治疗,单抗+介入组另予阿利西尤单抗联合神经介入治疗,药物治疗均 12 周.比较 2 组治疗效果、不良反应及治疗前后血脂指标、血液流变学、神经功能评分、预后情况评分、日常生活活动能力评分.结果 治疗 12 周后,单抗+介入组临床治疗总有效率高于神经介入组(90.70%vs.72.09%,χ2/P=4.914/0.027).单抗+介入组 TC、TG、LDL-C、ApoA1、ApoB 水平低于神经介入组,HDL-C 水平高于神经介入组(t/P=3.989/＜0.001、5.946/＜0.001、4.979/＜0.001、6.014/＜0.001、5.087/＜0.001、4.977/＜0.001);单抗+介入组 Fib 水平、血浆黏度、全血高切黏度、全血低切黏度低于神经介入组(t/P=4.851/＜0.001、5.902/＜0.001、4.186/＜0.001、4.486/＜0.001);单抗+介入组 NIHSS、mRS 评分低于神经介入组,MBI 评分高于神经介入组(t/P=5.164/＜0.001、8.962/＜0.001、4.387/＜0.001);2 组不良反应比较差异无统计学意义(P＞0.05).结论 阿利西尤单抗联合神经介入治疗老年他汀不耐受脑梗死合并高脂血症患者的疗效显著,可改善血脂代谢、血液流变学,并可减轻神经功能缺损程度,改善预后情况,提高日常生活活动能力.
Objective To investigate the efficacy of alirocumab combined with neurointerventional therapy in treating elderly patients with cerebral infarction complicated by hyperlipidemia who are intolerant to statins.Methods A total of 86 elderly patients with cerebral infarction complicated by hyperlipidemia who were intolerant to statins and admitted to the Department of Neurology,General Hospital of Taiyuan Iron and Steel(Group)Co.,Ltd.from January 2020 to August 2024 were retrospectively selected.They were divided into a conventional group and a combined group according to different treat-ment regimens,with 43 cases in each group.Both groups received basic treatment.The conventional group additionally re-ceived neurointerventional therapy,while the combined group received alirocumab combined with neurointerventional therapy.Therapeutic efficacy,adverse reactions,as well as lipid profiles,hemorheology,neurological function scores,prognosis scores,and activities of daily living scores before and after treatment were compared between the two groups.Results The total ef-fective rate in the combined group was significantly higher than that in the conventional group(χ2=4.914,P=0.027).After 12 weeks of treatment,levels of TC,TG,LDL-C,ApoA1,and ApoB decreased,while HDL-C increased in both groups,with more pronounced changes in the combined group(t=3.989,5.946,4.979,6.014,5.087,4.977,all P<0.001).The combined group had significantly lower levels of FIB,plasma viscosity,whole blood high-shear viscosity,and whole blood low-shear viscosity than the conventional group(t=4.851,5.902,4.186,4.486,all P<0.001).NIHSS and mRS scores decreased,while MBI scores increased in both groups,with more marked improvements in the combined group(t=5.164,8.962,4.387,all P<0.001).No significant difference was observed in the incidence of adverse reactions between the two groups(P>0.05).Con-clusion The combination of alirocumab and neurointerventional therapy demonstrates significant efficacy in elderly patients with cerebral infarction complicated by hyperlipidemia who are intolerant to statins.It can improve lipid metabolism and he-morheology,reduce neurological impairment,enhance prognosis,and improve activities of daily living.
陈彦军;孙博;张龙兴;孔瑜;吴雪梅
030008 太原,太原钢铁(集团)有限公司总医院神经内科030032 太原,山西白求恩医院神经内科030008 太原,太原钢铁(集团)有限公司总医院神经内科030012 太原,山西省人民医院急诊科030008 太原,太原钢铁(集团)有限公司总医院神经内科
医药卫生
脑梗死高脂血症阿利西尤单抗神经介入治疗阿托伐他汀血脂神经功能评分疗效
Cerebral infarctionHyperlipidemiaAlirocumabNeurointerventionAtrovastatinBlood lipidsNeuro-logical function scoreTherapeutic effect
《疑难病杂志》 2026 (8)
939-944,6
山西省应用基础研究计划项目(202103021224449) Shanxi Provincial Basic Research Program Project(202103021224449)
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