Nakajima Fumitaka, Morimoto Satoshi, Yurugi Takatomi, Amari Yoshihumi, Kasuno Yuko, Fukui Masayoshi, Furumatsu Yoshiyuki, Kitamura Tetsuya
Department of Nephrology, Moriguchi Keijinkai Hospital, Moriguchi, Osaka, Japan.
Int J Artif Organs. 2012 Nov;35(11):981-5. doi: 10.5301/ijao.5000127.
The prevalence of thrombotic cerebral infarction is higher in dialysis than in general patients. Changes in cerebral blood flow (CBF) during low-density lipoprotein cholesterol-apheresis (LDL-A) in dialysis patients with arteriosclerosis obliterans (ASO) were evaluated employing xenon-CT (Xe-CT) to investigate the possibility of CBF improvement.
Xe-CT was performed before LDL-A in 4 dialysis patients with ASO (3 males and 1 female). LDL-A was then performed once a week 10 times. After the completion of LDL-A treatment, Xe-CT was performed again to observe changes in CBF.
Before treatment, CBF in the 4 patients was lower than that in the general population in the same age group. After LDL-A treatment, CBF was improved. The improvement was observed in the cerebral cortex rather than the basal ganglia. The grade of improvement and improved cerebral region varied among the patients.
It was suggested that LDL-A may improve not only lower limb blood flow but also CBF. However, further investigation is necessary with regard to the influence of CBF improvement on the brain function and clinical application. The reported results need to be confirmed in larger studies.
透析患者血栓性脑梗死的患病率高于普通患者。采用氙CT（Xe-CT）评估动脉硬化闭塞症（ASO）透析患者进行低密度脂蛋白胆固醇吸附（LDL-A）治疗期间脑血流量（CBF）的变化，以研究改善CBF的可能性。
对4例ASO透析患者（3例男性，1例女性）在LDL-A治疗前进行Xe-CT检查。然后每周进行1次LDL-A治疗，共10次。LDL-A治疗结束后，再次进行Xe-CT检查以观察CBF的变化。
治疗前，4例患者的CBF低于同年龄组的普通人群。LDL-A治疗后，CBF得到改善。改善见于大脑皮质而非基底神经节。患者之间的改善程度和改善的脑区各不相同。
提示LDL-A不仅可能改善下肢血流，还可能改善CBF。然而，关于CBF改善对脑功能的影响及临床应用，仍需进一步研究。报道的结果需要在更大规模的研究中得到证实。
