Morsch G, Maywald F, Wanner C
B. Braun Melsungen AG, Sparte Medizintechnik, Abt. Extrakorporale Blutbehandlung, Melsungen, Germany.
Bioseparation. 1995 Feb;5(1):11-8.
Heparin-induced extracorporeal LDL-precipitation has successfully been used in lowering high serum cholesterol in patients with coronary heart disease due to familial hypercholesterolemia. In the continuous search to improve treatment facilities we attempted to increase the filtration capacity of low density lipoprotein by the precipitate filter of the H.E.L.P.-system. Therefore, the nominal filtration area was varied by decreasing the pleat count as well as the configuration of the precipitation filter membrane. The device was tested in vitro using fresh frozen plasma from healthy donors as well as in vivo treating 6 patients suffering from familial hypercholesterolemia and 18 patients with the nephrotic syndrome. The data show that the drop in pressure on the filtration side depended on the filtration volume and the filter configuration. Reducing the pleat number and in parallel the nominal filtration area by replacing the standard support on the outside of the membrane by a double or triple thick support results in an increase in plasma volume which can be treated. The optimal results were obtained using filters with a nominal filtration area of 0.8 +/- 0.1 m2 and a triple thick support on the retention side compared to the standard configuration. Therefore, even patients with extreme plasma viscosity such as patients with the nephrotic syndrome can effectively be treated by heparin-induced LDL-precipitation.
肝素诱导的体外低密度脂蛋白沉淀已成功用于降低因家族性高胆固醇血症导致冠心病患者的高血清胆固醇。在不断寻求改善治疗设备的过程中，我们试图通过H.E.L.P.系统的沉淀过滤器提高低密度脂蛋白的过滤能力。因此，通过减少褶数以及沉淀过滤膜的结构来改变标称过滤面积。该设备在体外使用健康供体的新鲜冷冻血浆进行了测试，并在体内对6名家族性高胆固醇血症患者和18名肾病综合征患者进行了治疗。数据表明，过滤侧的压力下降取决于过滤体积和过滤器结构。通过用双层或三层厚的支撑物代替膜外侧的标准支撑物来减少褶数并同时减少标称过滤面积，可使可处理的血浆体积增加。与标准配置相比，使用标称过滤面积为0.8 +/- 0.1平方米且在保留侧有三层厚支撑物的过滤器可获得最佳结果。因此，即使是血浆粘度极高的患者，如肾病综合征患者，也可通过肝素诱导的低密度脂蛋白沉淀得到有效治疗。
