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血浆系统的去脂体外脂蛋白过滤器:一种用于急性缺血性中风患者的新型强化降脂疗法。

Delipid extracorporeal lipoprotein filter from plasma system: a new intensive lipid lowering therapy for patients with acute ischemic stroke.

作者信息

Jiao Yuqiong, Yang Qi, Ye Ting, Zhu Jun, Li Qunyi, Han Xiang, Dong Qiang

机构信息

Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Front Neurol. 2024 Mar 6;15:1342751. doi: 10.3389/fneur.2024.1342751. eCollection 2024.

Abstract

OBJECTIVES

To investigate the safety and efficacy of the delipid extracorporeal lipoprotein filter from plasma (DELP) system, a new low-density lipoprotein cholesterol (LDL-C) adsorption system, in acute ischemic stroke (AIS) patients.

PATIENTS AND METHODS

In the present study, a total of 180 AIS patients were enrolled during March 2019 to February 2021. They were divided into DELP group ( = 90) and the control group ( = 90). The treatment protocol and vascular access of DELP treatment was established and evaluated. For the DELP group, clinical data and laboratory results including plasma lipid and safety parameters before and after the apheresis were collected and analyzed. For all participants, neurological scores were assessed and recorded.

RESULTS

For the DELP group, 90 patients including 70 males and 20 females were included. The mean LDL-C was significantly decreased from 3.15 ± 0.80 mmol/L to 2.18 ± 0.63 mmol/L (30.79%,  < 0.001) during a single DELP treatment, and decreased from 3.42 ± 0.87 mmol/L to 1.87 ± 0.48 mmol/L (45.32%,  < 0.001) after two DELP treatments. No clinically relevant changes were observed in hematologic safety parameters and blood pressure levels except for hematocrit and total protein throughout the whole period of DELP treatment. The DELP group showed improvement relative to the control group in National Institute of Health stroke scale scores (NIHSS) on the 14th and 90th day after stroke. Moreover, the DELP group had a significantly higher ratio of mRS 0 to 1 on the 90th day after stroke.

CONCLUSION

The new LDL-C adsorption system, the DELP system, may provide a new option for intensive lipid lowering therapy in AIS patients in view of its safety, efficacy, and operation feasibility.

摘要

目的

探讨一种新型低密度脂蛋白胆固醇(LDL-C)吸附系统——血浆去脂体外脂蛋白滤过(DELP)系统在急性缺血性卒中(AIS)患者中的安全性和有效性。

患者与方法

在本研究中,2019年3月至2021年2月期间共纳入180例AIS患者。他们被分为DELP组(n = 90)和对照组(n = 90)。建立并评估了DELP治疗的方案和血管通路。对于DELP组,收集并分析了血浆置换前后的临床数据和实验室结果,包括血脂和安全参数。对所有参与者进行神经学评分并记录。

结果

DELP组纳入90例患者,其中男性70例,女性20例。单次DELP治疗期间,平均LDL-C从3.15±0.80 mmol/L显著降至2.18±0.63 mmol/L(降低30.79%,P<0.001),两次DELP治疗后从3.42±0.87 mmol/L降至1.87±0.48 mmol/L(降低45.32%,P<0.001)。在整个DELP治疗期间,除血细胞比容和总蛋白外,血液学安全参数和血压水平未观察到临床相关变化。与对照组相比,DELP组在卒中后第14天和第90天的美国国立卫生研究院卒中量表(NIHSS)评分有所改善。此外,在卒中后第90天,DELP组的改良Rankin量表(mRS)评分为0至1的比例显著更高。

结论

新型LDL-C吸附系统DELP系统鉴于其安全性、有效性和操作可行性,可能为AIS患者的强化降脂治疗提供新的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c85/10950928/40d7391cc18e/fneur-15-1342751-g001.jpg

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