Tünnemann-Tarr Adrienn, Katzmann Julius Ludwig, Thiery Joachim, Laufs Ulrich
Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland.
Dekanat der Medizinischen Fakultät, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland.
Herz. 2022 Jun;47(3):228-235. doi: 10.1007/s00059-022-05115-9. Epub 2022 Apr 22.
Lipoprotein apheresis is an extracorporeal procedure for the treatment of patients with homozygous familial hypercholesterolemia, patients with severe treatment-resistant hypercholesterolemia and patients with lipoprotein(a) hypercholesterolemia, who show progressive atherosclerotic cardiovascular disease despite optimal treatment. This article reports on the historical developments of the procedures, the most frequently used methods for apheresis as well as the data situation on efficacy and tolerability. Randomized prospective studies on clinical outcomes are not available. Furthermore, the article reports on a patient with homozygous familial hypercholesterolemia and 34 years of treatment with heparin-induced extracorporeal low-density lipoprotein (LDL) precipitation (HELP) apheresis, the longest treatment of this kind worldwide. A second patient with combined heterozygous familial hypercholesterolemia and 31 years of liposorber and HELP apheresis is also described. The observational studies and the case reports demonstrate the safety and long-term tolerability of the procedure.
脂蛋白分离术是一种体外治疗方法，用于治疗纯合子家族性高胆固醇血症患者、严重难治性高胆固醇血症患者以及脂蛋白(a)高胆固醇血症患者，这些患者尽管接受了最佳治疗，但仍表现出进行性动脉粥样硬化性心血管疾病。本文报道了该治疗方法的历史发展、最常用的分离术方法以及疗效和耐受性的数据情况。目前尚无关于临床结局的随机前瞻性研究。此外，本文还报道了一名纯合子家族性高胆固醇血症患者，接受肝素诱导的体外低密度脂蛋白（LDL）沉淀（HELP）分离术治疗34年，这是全球此类治疗时间最长的案例。还描述了另一名患有复合杂合子家族性高胆固醇血症的患者，接受脂质吸附器和HELP分离术治疗31年。观察性研究和病例报告证明了该治疗方法的安全性和长期耐受性。
