2023 年第 5 期 第 18 卷

前蛋白转化酶枯草溶菌素9抑制剂在冠心病中的研究进展

Research progress of proprotein convertase subtilisin/kexin type 9 inhibitors in coronary atherosclerotic heart disease

作者：龚乙洪1覃润1陈璐2何艳2

英文作者：Gong Yihong1 Qin Run1 Chen Lu2 He Yan2

单位：1贵州医科大学，贵阳550000；2贵州医科大学附属医院心血管内科，贵阳550000

英文单位：1Guizhou Medical University Guiyang 550000 China; 2Department of Cardiovascular Medicine the Affiliated Hospital of Guizhou Medical University Guiyang 550000 China

关键词：前蛋白转化酶枯草溶菌素9抑制剂；冠心病（冠状动脉粥样硬化性心脏病）；代谢综合征；主要不良心血管事件

英文关键词：Proproteinconvertasesubtilisin/kexintype9inhibitors;Coronaryatheroscleroticheartdisease;Metabolicsyndrome;Majoradversecardiovascularevents

• 摘要：

• 代谢综合征（MS）与冠心病（冠状动脉粥样硬化性心脏病）的风险增加有关，大多数冠心病患者合并有多种代谢危险因素，高强度他汀类药物治疗已被证明可降低MS和冠心病患者发生主要不良心血管事件的风险。然而，MS患者的残余风险仍然很高，前蛋白转化酶枯草溶菌素9（PCSK9）抑制剂作为低密度脂蛋白治疗的新目标，通过与循环PCSK9结合并阻止其与低密度脂蛋白受体结合，加速清除低密度脂蛋白颗粒，从而使血浆低密度脂蛋白胆固醇水平大幅下降。最近研究表明冠心病合并MS患者可在PCSK9抑制剂治疗中获益。本文就PCSK9抑制剂在冠心病中的研究进展作一综述。

• Metabolic syndrome (MS) is associated with an increased risk of coronary atherosclerotic heart disease, and most patients with coronary atherosclerotic heart disease have a combination of multiple metabolic risk factors. High-intensity statin therapy has been shown to reduce the risk of major adverse cardiovascular events (MACE) in patients with MS and coronary atherosclerotic heart disease. However, the residual risk remains high in MS patients. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a new target for low-density lipoprotein (LDL) therapy, accelerate the clearance of LDL particles by binding to circulating PCSK9 and preventing it from binding to the low-density lipoprotein receptor, resulting in a substantial reduction of plasma low-density lipoprotein granule level. Recent studies have shown that PCSK9 inhibitors may be beneficial in the treatment of MS combined with coronary atherosclerotic heart disease. This article reviews the progress of PCSK9 inhibitors in coronary atherosclerotic heart disease.