新型脂蛋白吸附治疗对无选择的慢性肢体威胁性缺血的临床影响：来自 REDUCTION VISCOSITY 研究的结果。
Clinical impact of a novel lipoprotein apheresis treatment on no-option chronic limb-threatening ischemia: Result from the REDUCTION VISCOSITY study.
机构信息
Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan.
Division of Vascular Surgery, The Jikei University School of Medicine, Tokyo, Japan.
出版信息
Ther Apher Dial. 2023 Oct;27(5):960-967. doi: 10.1111/1744-9987.13991. Epub 2023 Apr 13.
INTRODUCTION
Lipoprotein apheresis (LA) is a possible adjunct treatment for no-option chronic limb-threatening ischemia (CLTI). This study aimed to assess the impact of a novel LA for no-option CLTI.
METHODS
We retrospectively assessed 19 patients with no-option CLTI treated using the novel LA. The primary outcome was a change in the skin perfusion pressure (SPP) after treatment with LA, and the secondary outcomes were changes in the viscosity-related laboratory parameters.
RESULTS
The wound-healing rate was 68.4%. The SPP at 2-3 weeks after series of LA were significantly higher both in the dorsal (41 vs. 53 mmHg, p = 0.037) and plantar (50.0 vs. 61.0 mmHg, p = 0.018) sides, compared to those at baseline. The viscosity-related laboratory markers were also significantly improved after the treatment; low-density lipoprotein-cholesterol (57.0 vs. 43.0 mg/dL, p = 0.002), fibrinogen (333 vs. 258 mg/dL, p < 0.001), and C-reactive protein (0.99 vs. 0.42 mg/dL, p = 0.001).
CONCLUSION
The novel LA significantly increased the SPP and improved relevant laboratory findings.
简介
脂蛋白吸附（LA）是一种治疗无选择慢性肢体威胁性缺血（CLTI）的可能辅助治疗方法。本研究旨在评估新型 LA 对无选择 CLTI 的影响。
方法
我们回顾性评估了 19 例采用新型 LA 治疗的无选择 CLTI 患者。主要结局是 LA 治疗后皮肤灌注压（SPP）的变化，次要结局是与粘度相关的实验室参数的变化。
结果
创面愈合率为 68.4%。LA 系列治疗后 2-3 周，背侧（41 对 53mmHg，p=0.037）和足底（50.0 对 61.0mmHg，p=0.018）的 SPP 明显高于基线。治疗后与粘度相关的实验室标志物也明显改善；低密度脂蛋白胆固醇（57.0 对 43.0mg/dL，p=0.002）、纤维蛋白原（333 对 258mg/dL，p<0.001）和 C 反应蛋白（0.99 对 0.42mg/dL，p=0.001）。
结论
新型 LA 显著增加了 SPP，并改善了相关的实验室发现。
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