2025 年第 5 期 第 20 卷

血脂康胶囊联合阿利西尤单抗对他汀类药物不耐受动脉粥样硬化性心血管疾病患者动脉硬化程度和血脂水平的影响

The effect of Xuezhikang capsule combined with alirocumab on the degree of atherosclerosis and blood lipid levels in patients with atherosclerotic cardiovascular disease intolerant to statins

作者：吴洁琼1李红月2王佳星2田丹丹3刘育慧1倪晨1耿清峰1钱云1

英文作者：Wu Jieqiong1 Li Hongyue2 Wang Jiaxing2 Tian Dandan3 Liu Yuhui1 Ni Chen1 Geng Qingfeng1 Qian Yun1

单位：1河北省第七人民医院河北中医药大学第二附属医院心血管病科，保定073000；2河北省第七人民医院河北中医药大学第二附属医院检验科，保定073000；3河北省第七人民医院河北中医药大学第二附属医院肾内科，保定073000

英文单位：1Department of Cardiovascular Disease the Seventh People′s Hospital of Hebei Province the Second Affiliated Hospital of Hebei University of Chinese Medicine Baoding 073000 China; 2Department of Laboratory Medicine the Seventh People′s Hospital of Hebei Province the Second Affiliated Hospital of Hebei University of Chinese Medicine Baoding 073000 China; 3Department of Nephrology the Seventh People′s Hospital of Hebei Province the Second Affiliated Hospital of Hebei University of Chinese Medicine Baoding 073000 China

关键词：动脉粥样硬化性心血管疾病；他汀类药物不耐受；血脂康胶囊；阿利西尤单抗；动脉硬化程度；血脂

英文关键词：Atheroscleroticcardiovasculardisease;Statinintolerance;Xuezhikangcapsule;Aliciumab;Degreeofarteriosclerosis;Bloodlipid

• 摘要：

• 目的 探究血脂康胶囊联合阿利西尤单抗对他汀类药物不耐受动脉粥样硬化性心血管疾病（ASCVD）患者动脉硬化程度和血脂水平的影响。方法 研究对象为河北中医药大学第二附属医院在2022年6月至2024年8月收治的80例他汀类药物不耐受ASCVD患者。按随机数字表法分为观察组（41例）和对照组（39例）。对照组给予阿利西尤单抗治疗；观察组在对照组基础上联合血脂康胶囊治疗；2组均连续治疗12周。比较2组患者治疗后动脉硬化程度、血脂指标、低密度脂蛋白胆固醇（LDL-C）达标率、LDL-C降低＞50%达标率、不良反应发生情况和临床总有效率。结果 治疗4、8、12周后，观察组LDL-C、甘油三酯、总胆固醇、肌酸激酶、谷氨酸、肌酸激酶同工酶水平和心踝血管指数、臂踝脉搏波传导速度均明显低于对照组，高密度脂蛋白胆固醇、脂蛋白a、总胆红素、天冬氨酸转氨酶、丙氨酸转氨酶水平和踝肱指数均高于对照组，差异均有统计学意义（均P＜0.05）。观察组LDL-C达标率、LDL-C降低＞50%达标率、总有效率均高于对照组［78.0%(32/41)比35.9%(14/39)、95.1%(39/41)比41.0%(16/39)、97.6%(40/41)比79.5%(31/39)］，差异均有统计学意义（均P＜0.05）。2组不良反应总发生率比较差异无统计学意义（P=0.107）。结论 他汀类药物不耐受ASCVD患者行血脂康胶囊、阿利西尤单抗联合治疗可明显改善动脉硬化程度，提高LDL-C达标率，临床疗效显著，且安全性高。

• Objective To investigate the effects of Xuezhikang capsule combined with alirocumab on the degree of atherosclerosis and blood lipid levels in patients with atherosclerotic cardiovascular disease (ASCVD) intolerant to statins. Methods Eighty ASCVD patients with statin intolerance admitted to the Second Affiliated Hospital of Hebei University of Chinese Medicine from June 2022 to August 2024 were enrolled. According to random number table method, they were divided into observation group (41 cases) and control group (39 cases). The control group was treated with alirocumab. The observation group was treated with Xuezhikang capsule on the basis of the control group. Both groups were treated for 12 weeks. The degree of arteriosclerosis, blood lipid indexes, the standard-reaching rate of low-density lipoprotein cholesterol (LDL-C), the standard-reaching rate of LDL-C reduction > 50%, the incidence of adverse reactions and the total effective rate were compared between the two groups after treatment. Results After 4, 8 and 12 weeks of treatment, the levels of LDL-C, triglyceride, total cholesterol, creatine kinase, glutamate, creatine kinase isoenzyme, cardio-ankle vascular index and brachial-ankle pulse wave velocity in the observation group were significantly lower than those in the control group; high density lipoprotein cholesterol, lipoprotein a, total bilirubin, aspartate aminotransferase, alanine aminotransferase, and ankle brachial index were higher than those in the control group (all P＜0.05). The compliance rate of LDL-C, the compliance rate of LDL-C reduction > 50% and the total effective rate in the observation group were higher than those in the control group ［78.0%(32/41) vs 35.9%(14/39), 95.1%(39/41) vs 41.0%(16/39), 97.6%(40/41) vs 79.5%(31/39)］(all P＜0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P=0.107). Conclusion Xuezhikang capsule combined with alirocumab in the treatment of ASCVD patients with statin intolerance can significantly improve the degree of atherosclerosis and the rate of LDL-C reaching the standard, with significant clinical efficacy and high safety.