Naganuma S, Agishi T, Ota K
Department of Surgery, Tokyo Women's Medical College, Japan.
ASAIO J. 1992 Jul-Sep;38(3):M436-9. doi: 10.1097/00002480-199207000-00071.
Low density lipoprotein (LDL) apheresis was carried out in 28 atherosclerotic patients with clinical signs of poor peripheral circulation and abnormally high LDL levels. The LDL apheresis using extracorporeal adsorption with a dextran sulfate cellulose column (Liposorber, Kaneka, Japan) was done 10 times over 3 months. Hyperlipidemia was rapidly corrected after the initial two aphereses, whereas clinical signs of arteriosclerosis obliterans (ASO), such as coldness of the legs in 17 of 19 patients (89.5%), intermittent claudication in 14 of 17 patients (82.4%), foot pain at rest in 15 of 18 patients (83.3%), poor arterial pulsation in 12 of 16 patients (75.0%), and diminution of ulcer/necrosis in 3 of 5 patients (60.0%), improved in parallel. Improvement in plethysmographic and thermographic findings were observed in 10 of 10 patients (100.0%) and 13 of 14 patients (92.9%), respectively. Our tentative conclusion is that LDL apheresis using the Liposorber system was very effective in removing LDL from blood, and clinical symptoms rapidly improved in all patients concomitant with a reduction in plasma LDL levels. Hyperlipidemia may be a risk factor for symptomatic ASO in the lower extremities, and its active correction may be worth trying.
对28例有外周循环不良临床体征且低密度脂蛋白（LDL）水平异常升高的动脉粥样硬化患者进行了低密度脂蛋白去除术。使用硫酸葡聚糖纤维素柱（Liposorber，日本Kaneka公司）进行体外吸附的低密度脂蛋白去除术在3个月内进行了10次。最初两次去除术后高脂血症迅速得到纠正，同时，19例患者中有17例（89.5%）腿部发冷、17例患者中有14例（82.4%）间歇性跛行、18例患者中有15例（83.3%）静息时足部疼痛、16例患者中有12例（75.0%）动脉搏动减弱以及5例患者中有3例（60.0%）溃疡/坏死减轻等闭塞性动脉硬化（ASO）的临床体征也得到了相应改善。分别在10例患者中的10例（100.0%）和14例患者中的13例（92.9%）观察到体积描记法和热像图检查结果有所改善。我们初步得出的结论是，使用Liposorber系统进行低密度脂蛋白去除术在从血液中清除LDL方面非常有效，并且所有患者的临床症状随着血浆LDL水平的降低而迅速改善。高脂血症可能是下肢有症状性ASO的一个危险因素，积极纠正高脂血症可能值得一试。
