Department of Internal Medicine, College ofMedicine, Chung-Ang University, Seoul, Korea.
Am J Cardiol. 2011 Mar 1;107(5):793-6. doi: 10.1016/j.amjcard.2010.10.063. Epub 2011 Jan 19.
Type III hyperlipoproteinemia is a rare familial disease characterized by marked elevations of serum cholesterol and triglyceride levels caused by an accumulation of remnant lipoproteins in apolipoprotein E2/E2 homozygotes. It is associated with an increased risk for premature atherosclerotic vascular disease. A 55-year-old woman was diagnosed as having type III hyperlipoproteinemia on the basis of skin lesions, serum lipid levels, lipid electrophoresis, and apolipoprotein E genotyping and stable angina pectoris on the basis of typical symptoms and treadmill exercise electrocardiographic results. After 1 year of combination therapy with atorvastatin and fenofibrate, skin xanthomata disappeared, leaving minimal remnants. In addition, there was no exertional chest pain, and treadmill exercise electrocardiographic results were negative. This finding was confirmed by coronary computed tomographic angiography. This case suggests that proper medical therapy can induce the regression of uncomplicated coronary lesions in type III hyperlipoproteinemia.
III 型高脂蛋白血症是一种罕见的家族性疾病，其特征为载脂蛋白 E2/E2 纯合子患者体内残余脂蛋白堆积，导致血清胆固醇和甘油三酯水平显著升高。III 型高脂蛋白血症与早发动脉粥样硬化性血管疾病风险增加相关。一名 55 岁女性因皮肤病变、血清脂质水平、脂质电泳以及载脂蛋白 E 基因分型，被诊断为 III 型高脂蛋白血症。根据典型症状和跑步机运动心电图结果，该患者还患有稳定性心绞痛。经过阿托伐他汀和非诺贝特联合治疗 1 年后，皮肤黄斑瘤消失，仅残留少量痕迹。此外，患者无运动性胸痛，跑步机运动心电图结果为阴性。冠状动脉计算机断层血管造影术证实了这一发现。该病例表明，适当的药物治疗可使 III 型高脂蛋白血症患者的非复杂性冠状动脉病变消退。
