Keller C
Medizinische Poliklinik der Universität, München, F.R.G.
Atherosclerosis. 1991 Jan;86(1):1-8. doi: 10.1016/0021-9150(91)90093-i.
LDL-apheresis (immunoabsorption, heparin precipitation (HELP), dextran sulfate cellulose binding (DSC) or filtration) is a potent therapeutic tool in familial hypercholesterolemia (FH) to eliminate LDL-cholesterol, Lp(a) or fibrinogen from the circulation and improve blood rheology. Repetitive use can deplete the cholesterol pool between 40 and 80%. As first reports showed, progression of coronary atherosclerosis can be stopped and sometimes regression can be induced. So far the domain of plasmapheresis was homozygous familial hypercholesterolemia. With several apheresis methods now available, it seems timely to define the indication of plasma therapy for heterozygous FH and the place of this potent therapeutic tool in primary and secondary prevention of atherosclerotic coronary heart disease in patients suffering from severe hypercholesterolemia resistant to diet and/or drug therapy.
低密度脂蛋白去除术（免疫吸附、肝素沉淀法（HELP）、硫酸葡聚糖纤维素结合法（DSC）或过滤法）是治疗家族性高胆固醇血症（FH）的一种有效治疗手段，可从循环中清除低密度脂蛋白胆固醇、脂蛋白（a）或纤维蛋白原，并改善血液流变学。重复使用可使胆固醇池减少40%至80%。正如最初的报告所示，冠状动脉粥样硬化的进展可以停止，有时还可诱导其消退。到目前为止，血浆置换术的适用范围是纯合子家族性高胆固醇血症。鉴于现在有多种去除术方法可用，确定杂合子FH的血浆治疗适应证以及这种有效治疗手段在饮食和/或药物治疗耐药的严重高胆固醇血症患者动脉粥样硬化性冠心病一级和二级预防中的地位似乎很及时。
