Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China.
Blood Purif. 2024;53(6):493-499. doi: 10.1159/000536301. Epub 2024 Jan 16.
Recently, the incidence of hypertriglyceridemia-associated pancreatitis (HTG-AP) has been increasing. The pathogenesis of lipogenic pancreatitis is not fully understood. This study aimed to retrospectively analyze the laboratory data, clinical manifestations, and prognosis of patients with lipid-derived pancreatitis who received lipid purification, to explore whether lipid purification is a better treatment for acute hyperlipidemic pancreatitis.
In this study, we enrolled five subjects diagnosed with HTG-AP at the Second Xiangya Hospital of Central South University between 2021 and 2022. We collected demographic data, medical histories, clinical manifestations, and laboratory data. All patients received routine therapy. Blood lipid purification was conducted using the double filtration plasmapheresis (DFPP) method. Plasma was separated from blood cells and purified to remove cholesterol, triglycerides, and low-density lipoprotein (LDL). SPSS was used for statistical analyses.
Following a single lipoprotein apheresis (LA) treatment, significant improvements in serum lipid levels were observed. Three patients achieved triglyceride levels below 5.65 mmol/L within 24 h, while the remaining 2 patients experienced reductions of 82% and 78%, respectively. The average triglyceride level decreased from 36.82 to 7.27 mmol/L, representing an 80% reduction from baseline. Total cholesterol decreased by 59% on average, and LDL levels decreased by 69%. Statistically significant differences were observed in triglyceride and cholesterol levels before and after treatment. Four patients exhibited increased HDL levels posttreatment, while 1 patient showed a decrease. The average HDL/TC level was 21% higher after treatment.
LA in HTG-AP effectively improves clinical symptoms, rapidly lowers lipid levels, and achieves good therapeutic outcomes.
近来，与高甘油三酯血症相关的胰腺炎（HTG-AP）的发病率不断增加。脂源性胰腺炎的发病机制尚不完全清楚。本研究旨在回顾性分析中南大学湘雅二医院 2021 年至 2022 年间收治的 5 例脂源性胰腺炎患者的实验室数据、临床表现和预后，探讨脂质清除是否是治疗急性高脂血症性胰腺炎的更好方法。
本研究纳入了 2021 年至 2022 年在中南大学湘雅二医院诊断为 HTG-AP 的 5 例患者。我们收集了人口统计学数据、病史、临床表现和实验室数据。所有患者均接受常规治疗。采用双重滤过血浆置换（DFPP）法进行血脂净化。将血液中的血浆与血细胞分离并进行纯化，以去除胆固醇、甘油三酯和低密度脂蛋白（LDL）。采用 SPSS 进行统计学分析。
单次脂蛋白吸附（LA）治疗后，血清脂质水平显著改善。3 例患者在 24 小时内将甘油三酯水平降至 5.65mmol/L 以下，另外 2 例患者分别降低了 82%和 78%。甘油三酯平均水平从 36.82mmol/L 降至 7.27mmol/L，降幅为 80%。总胆固醇平均降低 59%，LDL 水平降低 69%。治疗前后的甘油三酯和胆固醇水平差异有统计学意义。4 例患者治疗后 HDL 水平升高，1 例患者降低。治疗后 HDL/TC 平均水平升高 21%。
LA 治疗 HTG-AP 可有效改善临床症状，迅速降低血脂水平，获得良好的治疗效果。
