Francis Adi, Levy Yishai
Department of Medicine A, Haemek Medical Center, Afula.
Harefuah. 2002 Feb;141(2):201-3, 221, 220.
The chylomicronemia syndrome is a disorder characterized by severe hypertriglyceridemia and massive accumulation of chylomicrons in plasma. This hypertriglyceridemia can lead to the development of eruptive xanthomas, lipemia retinalis, and is clinically important when plasma triglyceride levels predispose to pancreatitis (above 2000 mg/dl). Three genetic disorders have been described in which chylomicrons accumulate in plasma: familial lipoprotein lipase deficiency, familial apolipoprotein C-II deficiency, and familial inhibitor to lipoprotein lipase. In addition, chylomicronemia is seen in other states with the simultaneous occurrence of familial forms of moderate hypertriglyceridemia and other acquired causes for hypertriglyceridemia such as diabetes mellitus, certain drug therapies and alcohol use. Treatment should be directed at both the familial and the acquired disorder. This review discusses the chylomicronemia syndrome presenting the pathophysiologic characteristics of triglyceride and chylomicrons metabolism, diagnosis, prevalence and treatment.
乳糜微粒血症综合征是一种以严重高甘油三酯血症和血浆中乳糜微粒大量蓄积为特征的疾病。这种高甘油三酯血症可导致疹性黄瘤、视网膜脂血症的发生,当血浆甘油三酯水平易引发胰腺炎(高于2000mg/dl)时,在临床上具有重要意义。已描述了三种血浆中乳糜微粒蓄积的遗传性疾病:家族性脂蛋白脂肪酶缺乏症、家族性载脂蛋白C-II缺乏症和家族性脂蛋白脂肪酶抑制剂。此外,在同时存在家族性中度高甘油三酯血症和其他高甘油三酯血症的后天病因(如糖尿病、某些药物治疗和酒精使用)的其他状态下也可见乳糜微粒血症。治疗应针对家族性和后天性疾病。本综述讨论了乳糜微粒血症综合征,介绍了甘油三酯和乳糜微粒代谢的病理生理特征、诊断、患病率和治疗。