Agishi T, Naganuma S, Nakasato S, Kitajima K, Ota K, Ban K, Nomura M
Kidney Center, Tokyo Women's Medical College, Japan.
Angiology. 1993 Mar;44(3):222-7. doi: 10.1177/000331979304400308.
According to the authors' clinical analysis, about half of the patients who suffer from arteriosclerotic obstruction (ASO) in the lower extremity(-ies) with clinical manifestation are dyslipidemic (total cholesterol > or = 220 mg/dL or LDL cholesterol > or = 140 mg/dL). As suggested by clinical success in regression of ASO in the coronary arteries as a result of aggressive removal of LDL, LDL adsorption utilizing an extracorporeal circulation technique with a dextran sulfate/cellulose adsorbent column was applied in 33 patients (22 men and 11 women) with ASO. Clinical results obtained after a series of 10 LDL adsorption procedures as a standard showed encouraging success. Improvement in subjective symptoms was achieved as follows: 88.5% for cold lower extremity, 87.1% for intermittent claudication, 53.8% for leg/toe pain at rest, and 60% for disappearance/size diminution of ulcer/necrosis. Improvements in objective examination findings supported subjective ones: 85.7% by plethysmography, 81% by thermography and 70% by ankle pressure index. No serious complications or untoward effects were observed during or after the adsorption procedures. In conclusion, LDL adsorption appears to be a useful and safe tool in treatment of ASO patients with dyslipidemia.
根据作者的临床分析，约一半有临床表现的下肢动脉硬化闭塞症（ASO）患者存在血脂异常（总胆固醇≥220mg/dL或低密度脂蛋白胆固醇≥140mg/dL）。由于积极去除低密度脂蛋白（LDL）可使冠状动脉粥样硬化闭塞症（ASO）病情好转，临床效果良好，因此采用硫酸葡聚糖/纤维素吸附柱体外循环技术进行LDL吸附治疗33例ASO患者（男22例，女11例）。以10次LDL吸附治疗作为标准治疗方案，临床结果令人鼓舞。主观症状改善情况如下：下肢发冷改善率为88.5%，间歇性跛行改善率为87.1%，静息时腿部/脚趾疼痛改善率为53.8%，溃疡/坏死消失/缩小率为60%。客观检查结果的改善也支持了主观症状的改善：体积描记法改善率为85.7%，热成像法改善率为81%，踝压指数改善率为70%。在吸附治疗期间及之后未观察到严重并发症或不良影响。总之，LDL吸附似乎是治疗血脂异常ASO患者的一种有用且安全的方法。
