Nguyen Nguyen T, Nath Priti V, Mai Vinh Q, Shakir Mohamed K M, Hoang Thanh D
Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Division of Endocrinology, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
AACE Clin Case Rep. 2021 Jan 27;7(3):211-215. doi: 10.1016/j.aace.2021.01.006. eCollection 2021 May-Jun.
Severe hypertriglyceridemia carries increased health risks, including the development of pancreatitis. The objective of this study was to report on management of 2 cases with severe gestational hypertriglyceridemia.
In case 1, a 33-year-old pregnant woman presented with serum triglyceride level of 14 000 mg/dL after discontinuing hypolipidemic medications. She was treated with Lovaza 12 g/day, and serum triglyceride remained near normal at level of less than 800 mg mg/dL until delivery. In case 2, a 28-year-old patient (29 week gestation) presented with acute pancreatitis and triglycerides >4000 mg/dL. She was treated with Gemfibrozil, Lovaza, insulin infusion, subcutaneous heparin, and escalated to plasmapheresis. She successfully delivered a baby at the week of 36 and her triglyceride level was 304 mg/dL after that.
Case 1 was treated with high-dose Lovaza and case 2 was treated with plasmapheresis successfully. Triglyceride levels were reduced to less than 500 mg/dL until delivery of healthy babies in both cases.
Omega-3 fatty acids and plasmapheresis may be effective and safe to treat pregnant women with severe hypertriglyceridemia and pancreatitis.
严重高甘油三酯血症会增加健康风险，包括胰腺炎的发生。本研究的目的是报告2例严重妊娠性高甘油三酯血症的治疗情况。
病例1，一名33岁孕妇在停用降血脂药物后血清甘油三酯水平达到14000mg/dL。她接受了每天12g的ω-3脂肪酸乙酯治疗，直至分娩时血清甘油三酯水平一直维持在800mg/dL以下的正常水平附近。病例2，一名28岁患者（妊娠29周）出现急性胰腺炎，甘油三酯水平>4000mg/dL。她接受了吉非贝齐、ω-3脂肪酸乙酯、胰岛素输注、皮下注射肝素治疗，并升级为血浆置换。她在36周时成功分娩，之后甘油三酯水平为304mg/dL。
病例1采用高剂量ω-3脂肪酸乙酯治疗，病例2采用血浆置换治疗均获成功。两例患者在健康分娩前甘油三酯水平均降至500mg/dL以下。
ω-3脂肪酸和血浆置换对于治疗患有严重高甘油三酯血症和胰腺炎的孕妇可能是有效且安全的。
