Mellwig K P, Schmidt H K, Brettschneider-Meyer A, Meyer H, Jaeger B R, Walli A K, Seidel D, Horstkotte D
Kardiologische Klinik, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Bad Oeynhausen.
Internist (Berl). 2003 Apr;44(4):476-80. doi: 10.1007/s00108-002-0832-1.
In children with familial hypercholesterolemia, coronary heart disease requires both medical theraphy and LDL apheresis. We report a case of verified occlusion of the anterior descending branch of the left coronary artery in a 10-year-old patient. The pathological findings revealed by ergometry established the diagnosis. The goal was to achieve the greatest possible reduction of lipid parameters and fibrinogen by lowering plasma viscosity employing LDL apheresis. It is astonishing that this treatment is also well tolerated by children. The basic vascular approaches suffice and shunt operations are not absolutely necessary. The efficacy of this method became vividly apparent by the changes in the skin lesions. Additional angiographic follow-up and further clinical course wil provide information on the usefulness of this treatment strategy with maximum lipid theraphy and the expected improvement in prognosis.
在患有家族性高胆固醇血症的儿童中，冠心病需要药物治疗和低密度脂蛋白分离术。我们报告一例10岁患者左冠状动脉前降支经证实的闭塞病例。运动试验揭示的病理结果确立了诊断。目标是通过低密度脂蛋白分离术降低血浆粘度，尽可能最大程度地降低脂质参数和纤维蛋白原。令人惊讶的是，这种治疗儿童也能很好耐受。基本的血管治疗方法就足够了，分流手术并非绝对必要。这种方法的疗效通过皮肤病变的变化清晰显现。额外的血管造影随访和进一步的临床病程将提供关于这种采用最大程度脂质治疗的治疗策略的有效性以及预期预后改善情况的信息。
