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血浆置换:临床医生应该知道什么?

Apheresis: What Should a Clinician Know?

机构信息

Medical Department IV - Grosshadern, University Munich, Marchioninistraße 15, 81377, Munich, Germany.

出版信息

Curr Atheroscler Rep. 2023 Mar;25(3):77-83. doi: 10.1007/s11883-023-01081-7. Epub 2023 Jan 26.

Abstract

PURPOSE OF REVIEW

Apheresis is a treatment option for severe dyslipidemia which has been introduced approximately 40 years ago to clinical practice. This article reviews recent apheresis research progresses, including apheresis for elevated LDL-cholesterol and elevated lipoprotein(a).

RECENT FINDINGS

While the role of apheresis in treating more common forms of LDL-hypercholesterolemia has been reduced due to the development of new, very potent LDL-lowering drugs, it still plays an important role in treating patients with homozygous familial hypercholesterolemia and patients with severe lipoprotein(a) elevation. One apheresis session can decrease LDL-cholesterol, apoB, and lipoprotein(a) by approximately 65%, which results in a time averaged reduction of 30-50%. Although time-consuming, and expensive regular apheresis is very well tolerated and has been proven safe for decades. Apheresis remains a treatment option for severe dyslipidemia, especially in homozygous familial hypercholesterolemia and elevated lipoprotein(a), if other forms of therapy fail to achieve targets.

摘要

目的综述

血液净化疗法是一种治疗严重血脂异常的方法,大约 40 年前被引入临床实践。本文综述了最近的血液净化研究进展,包括用于升高的 LDL-胆固醇和脂蛋白(a)的血液净化疗法。

最近的发现

尽管由于新型强效 LDL 降低药物的发展,血液净化疗法在治疗更常见的 LDL-高胆固醇血症方面的作用已经降低,但它在治疗纯合子家族性高胆固醇血症患者和严重脂蛋白(a)升高的患者方面仍然发挥着重要作用。一次血液净化治疗可使 LDL-胆固醇、载脂蛋白 B 和脂蛋白(a)降低约 65%,从而使平均降低率达到 30-50%。虽然耗时且昂贵,但定期进行的血液净化治疗耐受性非常好,且数十年来已被证明是安全的。如果其他形式的治疗未能达到目标,血液净化仍然是严重血脂异常的治疗选择,尤其是在纯合子家族性高胆固醇血症和脂蛋白(a)升高的情况下。

相似文献

1
Apheresis: What Should a Clinician Know?血浆置换:临床医生应该知道什么?
Curr Atheroscler Rep. 2023 Mar;25(3):77-83. doi: 10.1007/s11883-023-01081-7. Epub 2023 Jan 26.
2
Current Role of Lipoprotein Apheresis.脂蛋白吸附术的当前作用。
Curr Atheroscler Rep. 2019 May 1;21(7):26. doi: 10.1007/s11883-019-0787-5.

本文引用的文献

3
Lipoprotein apheresis for lipoprotein(a) and cardiovascular disease.脂蛋白吸附术用于脂蛋白(a)和心血管疾病。
J Clin Lipidol. 2019 Nov-Dec;13(6):894-900. doi: 10.1016/j.jacl.2019.09.010. Epub 2019 Sep 21.
6
Current Role of Lipoprotein Apheresis.脂蛋白吸附术的当前作用。
Curr Atheroscler Rep. 2019 May 1;21(7):26. doi: 10.1007/s11883-019-0787-5.

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