Mii S, Mori A, Sakata H, Nakayama M, Tsuruta H
Department of Surgery, Nippon Steel Corporation Yawata Works Hospital, Kitakyushu-City, Japan.
Angiology. 1998 Mar;49(3):175-80. doi: 10.1177/000331979804900302.
To study the mechanism of efficacy of low-density lipoprotein (LDL) adsorption for arteriosclerosis obliterans (ASO), eight ASO patients without indication for bypass surgery underwent LDL apheresis twice a week for 5 weeks and the change in prostaglandin 12 (PGI2) and thromboxane A2 (TXA2) due to LDL apheresis was measured. The concentration of 6-keto-PGF1alpha, a metabolite of PGI2, in systemic venous blood significantly increased from 10.4 +/- 1.8 to 42.0 +/- 10.6 pg/mL (P<0.05) after one session of LDL apheresis, while no significant change of TXB2, a metabolite of TXA2, was encountered. The ratio of 6-keto-PGF1alpha/TXB2 also rose dramatically from 0.213 +/- 0.044 to 0.522 +/- 0.128 (P<0.05). In five patients, the ischemic clinical symptoms improved and both the concentration of 6-keto-PGF1alpha and the ratio of 6-keto-PGF1alpha/TXB2 increased significantly, whereas in three patients there was no effect on clinical symptoms and neither parameter changed. These results suggest that elevated production of PGI2 from vascular cells due to LDL apheresis might contribute to improvement of ischemic symptoms.
为研究低密度脂蛋白（LDL）吸附治疗闭塞性动脉硬化症（ASO）的疗效机制，8例无旁路手术指征的ASO患者每周接受2次LDL单采，共进行5周，并检测LDL单采后前列腺素12（PGI2）和血栓素A2（TXA2）的变化。一次LDL单采后，体循环静脉血中PGI2的代谢产物6-酮-前列腺素F1α（6-keto-PGF1α）浓度从10.4±1.8 pg/mL显著升高至42.0±10.6 pg/mL（P<0.05），而TXA2的代谢产物血栓素B2（TXB2）未出现显著变化。6-酮-前列腺素F1α/血栓素B2的比值也从0.213±0.044急剧升至0.522±0.128（P<0.05）。5例患者的缺血临床症状改善，6-酮-前列腺素F1α浓度及6-酮-前列腺素F1α/血栓素B2比值均显著升高，而3例患者的临床症状未受影响，两个参数均无变化。这些结果表明，LDL单采导致血管细胞PGI2生成增加可能有助于改善缺血症状。
