Nomura S, Kouzuma R, Komura T, Sadayasu T, Segawa J, Nakashima Y, Kuroiwa A
2nd Department of Internal Medicine, University of Occupational and Environmental Health Japan, School of Medicine.
Kokyu To Junkan. 1992 Mar;40(3):299-302.
A case showing the regression of coronary atherosclerosis by the treatment with LDL-apheresis, was reported. The patient was a 67-year old female with heterozygous familial hypercholesterolemia. She had noticed the xanthelasma or left cubital xanthoma at the age of 50 years old. She was informed about her high serum cholesterol level (greater than 350 mg/dl), and the abnormal thickness of her bilateral achilles tendon at the age of 61 years. As her serum cholesterol level did not decrease sufficiently with several lipid-lowering drugs, she was referred to our hospital in order to obtain treatment for it by LDL-apheresis at the age of 66 years. LDL-apheresis was performed once every two weeks with drugs such as probucol, cholestyramine and pravastatin. Her coronary angiogram after two and half years of LDL-apheresis showed a decrease of the coronary narrowing in segment 1 and segment 13 (from 96.8% to 74.6% in segment 1, and from 81.5% to 61.7% in segment 13, respectively). The thickness of her bilateral achilles tendons had also decreased from 18 mm in the right and 19 mm in the left to 14 mm in both, after receiving LDL-apheresis for two and half years. It is suggested from the result of this case that the regression of coronary atherosclerosis could be expected after treatment with LDL-apheresis in hypercholesterolemic patients.
报告了一例通过低密度脂蛋白去除术治疗使冠状动脉粥样硬化消退的病例。患者为一名67岁的女性，患有杂合子家族性高胆固醇血症。她在50岁时发现了睑黄瘤或左肘黄色瘤。61岁时被告知其血清胆固醇水平高（大于350mg/dl），且双侧跟腱厚度异常。由于使用几种降脂药物后她的血清胆固醇水平未充分降低，66岁时她被转诊至我院，以便通过低密度脂蛋白去除术进行治疗。每两周进行一次低密度脂蛋白去除术，并同时使用普罗布考、考来烯胺和普伐他汀等药物。低密度脂蛋白去除术两年半后她的冠状动脉造影显示1段和13段的冠状动脉狭窄程度降低（1段从96.8%降至74.6%，13段从81.5%降至61.7%）。接受低密度脂蛋白去除术两年半后，她双侧跟腱的厚度也从右侧18mm和左侧19mm降至双侧均为14mm。从该病例结果提示，高胆固醇血症患者经低密度脂蛋白去除术治疗后有望使冠状动脉粥样硬化消退。
