Lane D M, Alaupovic P, Knight-Gibson C, Dudley V S, Laughlin L O
Lipid and Lipoprotein Laboratory, Oklahoma Medical Research Foundation, Oklahoma City 73190, USA.
Am J Cardiol. 1995 Jun 1;75(16):1124-9. doi: 10.1016/s0002-9149(99)80743-7.
Heparin-induced extracorporeal low-density lipoprotein (LDL) precipitation (HELP) treatments selectively remove LDL with minimal effects on high-density lipoproteins (HDL), but limited data are available on effects between treatments. The levels of factors associated with increased coronary artery disease risk (atherogenic) among treatments may have therapeutic significance, especially for combined HELP and lipid-lowering drug therapy. Hypercholesterolemic and combined hyperlipidemic patients resistant to diet/drug therapy were treated with biweekly HELP therapy. Hypercholesterolemic patients received either lovastatin or no drug, whereas combined hyperlipidemic patients received gemfibrozil. Plasma lipid (total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol) and apolipoprotein A-I, A-II, B, C-III, and E levels were measured before treatment, then immediately, and 2, 4, 7, and 14 days after treatments (n = 28). Atherogenic factor (LDL cholesterol, total cholesterol, apolipoprotein B) levels decreased > 50% with treatment, gradually increasing over 14 days to pretreatment levels. Factors associated with reduced coronary artery disease risk (HDL cholesterol and apolipoproteins A-I and A-II) decreased 8% to 16% but recovered by 2 days. Components of triglyceride-rich lipoproteins (triglycerides and apolipoproteins C-III and E) decreased 38% to 55% with variable post-treatment recoveries. Lovastatin reduced pretreatment levels of atherogenic and triglyceride-rich lipoprotein components and slowed post-treatment increases compared with no drug therapy. Gemfibrozil produced changes similar to lovastatin. Drug therapy had little effect on factors associated with reduced coronary artery disease risk. HELP apheresis produced large reductions in plasma atherogenic factor levels with gradual return to pretreatment levels over 14 days, whereas antiatherogenic factors were minimally reduced and recovered rapidly.(ABSTRACT TRUNCATED AT 250 WORDS)
肝素诱导的体外低密度脂蛋白（LDL）沉淀（HELP）治疗可选择性去除LDL，对高密度脂蛋白（HDL）影响极小，但关于不同治疗之间效果的可用数据有限。治疗中与冠状动脉疾病风险增加（致动脉粥样硬化）相关的因子水平可能具有治疗意义，尤其是对于联合HELP和降脂药物治疗而言。对饮食/药物治疗耐药的高胆固醇血症和混合性高脂血症患者接受每两周一次的HELP治疗。高胆固醇血症患者接受洛伐他汀治疗或不接受药物治疗，而混合性高脂血症患者接受吉非贝齐治疗。在治疗前、治疗即刻以及治疗后2、4、7和14天测量血浆脂质（总胆固醇、甘油三酯、LDL胆固醇和HDL胆固醇）以及载脂蛋白A-I、A-II、B、C-III和E水平（n = 28）。治疗后，致动脉粥样硬化因子（LDL胆固醇、总胆固醇、载脂蛋白B）水平降低> 50%，在14天内逐渐回升至治疗前水平。与冠状动脉疾病风险降低相关的因子（HDL胆固醇以及载脂蛋白A-I和A-II）降低8%至16%，但在2天内恢复。富含甘油三酯脂蛋白的成分（甘油三酯以及载脂蛋白C-III和E）降低38%至55%，治疗后恢复情况各异。与不进行药物治疗相比，洛伐他汀降低了治疗前致动脉粥样硬化和富含甘油三酯脂蛋白成分的水平，并减缓了治疗后的回升。吉非贝齐产生了与洛伐他汀相似的变化。药物治疗对与冠状动脉疾病风险降低相关的因子影响很小。HELP血液分离术使血浆致动脉粥样硬化因子水平大幅降低，在14天内逐渐恢复至治疗前水平，而抗动脉粥样硬化因子仅略有降低且迅速恢复。（摘要截选至250词）
