Keller Christiane
Klinikum der Universität München, Medizinische Poliklinik-Innenstadt, Munich, Germany.
Ther Apher Dial. 2007 Feb;11(1):2-8. doi: 10.1111/j.1744-9987.2007.00449.x.
Lipoprotein (a) (Lp (a)) increases global cardiovascular risk, especially when LDL cholesterol is concomitantly elevated. Epidemiologic data show that Lp (a) concentration in plasma can be used to predict the risk of early atherogenesis in a dose-dependent manner and late stages of atherosclerosis are accelerated by elevated Lp (a). Therapeutic means to lower Lp (a) are limited. The most effective method to reduce plasma Lp (a) concentration significantly is therapeutic apheresis. Because apheresis is laborious and expensive, patients considered for this procedure should suffer from high Lp (a) concentrations, well beyond 50 mg/dL, and have manifested and progressive coronary heart disease despite maximal drug therapy. Experimental data and therapeutic results will be discussed in the present paper.
脂蛋白(a) [Lp(a)]会增加整体心血管疾病风险，尤其是在低密度脂蛋白胆固醇同时升高时。流行病学数据表明，血浆中Lp(a)浓度可用于以剂量依赖方式预测早期动脉粥样硬化发生风险，而Lp(a)升高会加速动脉粥样硬化后期进程。降低Lp(a)的治疗手段有限。显著降低血浆Lp(a)浓度的最有效方法是治疗性血液成分单采。由于血液成分单采费力且昂贵，考虑采用该方法的患者应具备Lp(a)浓度极高（远超50mg/dL）且尽管接受了最大程度药物治疗仍有明显且进展性冠心病的情况。本文将讨论实验数据和治疗结果。
