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代谢综合征中的治疗性血液成分分离术

Therapeutic Apheresis in Metabolic Syndrome.

作者信息

Voinov V A

机构信息

I.P. Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.

出版信息

Immunol Endocr Metab Agents Med Chem. 2018 May;18(1):38-54. doi: 10.2174/1871522218666180608114536.

Abstract

BACKGROUND

The metabolic syndrome unites three pathologies of the person - obesity, arterial hypertension and diabetes. In recent years the progressing of such distribution covering from 2.5% to 3.8% of the population with increase twice each 10-15 years is noted. Even at maintenance of level of sugar at diabetes accumulation of the secondary metabolites breaking small vessels isn't excluded. At the same time many life-endangering complications develop.

OBJECTIVE

To identify the possibilities of plasmapheresis in the prevention and treatment of complications of metabolic syndrome.

METHOD

Analysis of the world literature data on complications of metabolic syndrome and methods of their treatment.

RESULTS

At metabolic syndrome the frequency of strokes and myocardial infarctions there is twice more often than in population. For 5-9 years the general life expectancy decreases. Disorders of microcirculation at diabetes lead to a retinopathy with total loss of sight, a nephropathy from the outcome in a renal failure, to polyneuropathy and diabetic foot syndrome with high risk of high level amputations of the lower extremities. At the same time medicamentous therapy is not able to prevent such complications and almost only way of removal of these pathological metabolites is therapeutic apheresis, mainly the plasmapheresis. Data from our own studies confirm the effectiveness of such tactics.

CONCLUSION

Plasmapheresis has to be applied not only to the correction of already critical conditions, but also to their prevention.

摘要

背景

代谢综合征合并了人体的三种病症——肥胖、动脉高血压和糖尿病。近年来,这种病症的发病率呈上升趋势,覆盖人群从2.5%增至3.8%,每10至15年翻一番。即使在糖尿病患者血糖水平维持稳定的情况下,也不能排除破坏小血管的次生代谢产物的积累。与此同时,会出现许多危及生命的并发症。

目的

确定血浆置换在预防和治疗代谢综合征并发症方面的可能性。

方法

分析关于代谢综合征并发症及其治疗方法的世界文献数据。

结果

在代谢综合征患者中,中风和心肌梗死的发生率是普通人群的两倍。5至9年内总体预期寿命缩短。糖尿病患者的微循环障碍会导致视网膜病变直至完全失明、肾病发展至肾衰竭、多发性神经病变以及糖尿病足综合征,下肢高位截肢风险很高。与此同时,药物治疗无法预防这些并发症,而清除这些病理代谢产物的几乎唯一方法是治疗性血液成分单采术,主要是血浆置换。我们自己的研究数据证实了这种治疗策略的有效性。

结论

血浆置换不仅应用于纠正已经危急的状况,还应用于预防这些状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e042/6174637/e7ff345b7a4e/IEMAMC-18-38_F1.jpg

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