Qi Rundi, Liu Hailei, Li Xin, Chen Minglong
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Cardiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Curr Cardiol Rev. 2025;21(3):116-120. doi: 10.2174/011573403X343784241115055037.
Managing hypertriglyceridemia-induced acute pancreatitis (HTG-AP) can be challenging, particularly due to the need for rapid triglyceride reduction to below 500mg/dL (5.645 mmol/L).
This is a case describing a 39-year-old female patient who presented to the Emergency Department with acute abdominal pain resulting from severe HTG-AP. However, under conventional therapy with oral lipid-lowering drugs, the triglyceride levels remained uncontrolled. Oral moderate-intensity statins could not only reduce low-density lipoprotein cholesterol (LDLc) by 25%-50%. However, increasing the dose could not further reduce blood lipids while increasing the risk of liver damage. After the administration of proprotein convertase subtilisin/ kexin type 9 inhibitor (PCSK9i), the triglyceride levels were well controlled with no additional side effects, and the symptoms of the patients were completely relieved.
In cases of unsatisfactory lipid control under conventional therapy, PCSK9i may offer a viable option for managing HTG-AP.
管理高甘油三酯血症诱发的急性胰腺炎（HTG-AP）颇具挑战性，尤其是因为需要迅速将甘油三酯水平降至500mg/dL（5.645毫摩尔/升）以下。
本病例描述了一名39岁女性患者，因严重的HTG-AP导致急性腹痛而就诊于急诊科。然而，在口服降脂药物的传统治疗下，甘油三酯水平仍未得到控制。口服中等强度他汀类药物不仅可使低密度脂蛋白胆固醇（LDLc）降低25%-50%。然而，增加剂量并不能进一步降低血脂，反而会增加肝损伤风险。在给予前蛋白转化酶枯草溶菌素/9型可辛抑制剂（PCSK9i）后，甘油三酯水平得到良好控制，且无额外副作用，患者症状完全缓解。
在传统治疗下血脂控制不佳的病例中，PCSK9i可能为管理HTG-AP提供一个可行的选择。
