Weiss N
University Center for Vascular Medicine and Department of Internal Medicine III, Section Angiology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany.
Atheroscler Suppl. 2009 Dec 29;10(5):62-9. doi: 10.1016/S1567-5688(09)71814-8.
Lipid apheresis is an effective lipid-lowering treatment in drug unresponsive severely hypercholesterolemic patients with coronary artery disease. It results in symptomatic improvement, reduces progression of coronary atherosclerosis, and decreases coronary event rates. These effects are partly caused by aggressive lipid lowering itself and partly by unselective removal of high molecular weight proteins leading to improved hemorheology. This review summarizes current available data on the proposed mechanisms by which lipid apheresis acts anti-atherosclerotic and improves ischemic symptoms. Based on this, it discusses the putative effects of lipid apheresis on restoring patho-physiological processes involved in the development of symptoms of peripheral arterial disease and critical limb ischemia. The available clinical experience with lipid apheresis and rheopheresis in treating patients with peripheral arterial disease is then critically reviewed and put into the context of currently available treatment options.
脂质分离术是治疗药物难治性重度高胆固醇血症合并冠心病患者的一种有效降脂疗法。它能改善症状，减缓冠状动脉粥样硬化进展，并降低冠心病事件发生率。这些作用部分源于积极的降脂本身，部分源于非选择性去除高分子量蛋白质从而改善血液流变学。本综述总结了目前关于脂质分离术发挥抗动脉粥样硬化作用及改善缺血症状的潜在机制的可用数据。基于此，探讨了脂质分离术对恢复参与外周动脉疾病和严重肢体缺血症状发展的病理生理过程的假定作用。随后对脂质分离术和血液成分单采术治疗外周动脉疾病患者的现有临床经验进行了批判性回顾，并将其置于当前可用治疗方案的背景下。
