Dairou F, Assogba U, Bruckert E, De Gennes J L, Turpin G
Service d'Endocrinologie, Hôpital de la Pitié, Paris.
Ann Med Interne (Paris). 1994;145(5):328-32.
Severe hypercholesterolaemia include familial homozygous hypercholesterolaemia and certain heterozygous hypercholesterolaemias which become severe, due to spontaneous non-response to treatment or to iatrogenic side effects. Other causes include an associated overload in Lp(a) or uncontrolled atheromatous disease. Surgical treatment has been replaced by iterative LDL apheresis in these severe forms. Mean cholesterol and LDL cholesterol levels can be reduced by 41 to 63% and 49 to 68% respectively with LDL apheresis. In general, HDL cholesterol is protected in selective LDL apheresis. We observed similar decrease for apo B and LDL cholesterol levels. Fifty percent of the Lp(a) was removed in the 3 groups of patients studied.
严重高胆固醇血症包括家族性纯合子高胆固醇血症以及某些因对治疗自发无反应或医源性副作用而变得严重的杂合子高胆固醇血症。其他原因包括Lp(a)相关的负荷过重或未控制的动脉粥样硬化疾病。在这些严重形式中，手术治疗已被反复进行的低密度脂蛋白分离术所取代。通过低密度脂蛋白分离术，总胆固醇和低密度脂蛋白胆固醇水平平均可分别降低41%至63%和49%至68%。一般来说，在选择性低密度脂蛋白分离术中高密度脂蛋白胆固醇受到保护。我们观察到载脂蛋白B和低密度脂蛋白胆固醇水平有类似程度的降低。在所研究的三组患者中，50%的Lp(a)被清除。
