依洛尤单抗vs阿利西尤单抗：两种降脂“单抗”，有什么不同？
在他汀联合胆固醇吸收抑制剂治疗后，低密度脂蛋白胆固醇（LDL-C）仍未达标时，指南会建议加用PCSK9抑制剂。这类药物是全人源单克隆抗体，通过靶向阻断循环中的PCSK9蛋白，使肝脏表面的LDL受体免于降解，从而大幅提升LDL-C的清除能力，可在现有治疗基础上进一步降低LDL-C约50%～60%。
依洛尤单抗和阿利西尤单抗是目前国内上市的两种PCSK9抑制剂，均已纳入国家医保目录，价格大幅下降后可及性显著提升。两者作用靶点相同，降脂效力相当，均有大型心血管结局研究（CVOT）支持。但在抗体亚型、给药方案、适应证细节等方面，仍存在一些差异。临床上该怎么选？两种“降脂单抗”到底有什么不同？今天我们就通过一张长图，从分子结构、循证证据、剂量规格、适应证、医保政策等多个维度，帮大家理清楚这两个药的异同。
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