LDL-Apheresis: Technical and Clinical Aspects

被引:61
作者
Bambauer, Rolf [1 ]
Bambauer, Carolin [2 ]
Lehmann, Boris [3 ]
Latza, Reinhard [3 ]
Schiel, Ralf [4 ]
机构
[1] Inst Blood Purificat, D-66424 Homburg, Germany
[2] Main Hosp Darmstadt, D-64283 Darmstadt, Germany
[3] Lab Med, D-66386 St Ingbert, Germany
[4] Inselklin Heringsdorf GmbH, D-17424 Seebad Heringsdorf, Germany
来源
SCIENTIFIC WORLD JOURNAL | 2012年
关键词
LOW-DENSITY-LIPOPROTEIN; CORONARY-HEART-DISEASE; ANGIOGRAPHICALLY ASSESSED TRIAL; C-REACTIVE PROTEIN; LONG-TERM EFFICACY; FAMILIAL HYPERCHOLESTEROLEMIA; DEXTRAN SULFATE; RISK-FACTOR; ANAPHYLACTOID REACTIONS; CARDIOVASCULAR-DISEASE;
D O I
10.1100/2012/314283
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
The prognosis of patients suffering from severe hyperlipidemia, sometimes combined with elevated lipoprotein (a) levels, and coronary heart disease refractory to diet and lipid-lowering drugs is poor. For such patients, regular treatment with low-density lipoprotein (LDL) apheresis is the therapeutic option. Today, there are five different LDL-apheresis systems available: cascade filtration or lipid filtration, immunoadsorption, heparin-induced LDL precipitation, dextran sulfate LDL adsorption, and the LDL hemoperfusion. There is a strong correlation between hyperlipidemia and atherosclerosis. Besides the elimination of other risk factors, in severe hyperlipidemia therapeutic strategies should focus on a drastic reduction of serum lipoproteins. Despite maximum conventional therapy with a combination of different kinds of lipid-lowering drugs, sometimes the goal of therapy cannot be reached. Hence, in such patients, treatment with LDL-apheresis is indicated. Technical and clinical aspects of these five different LDL-apheresis methods are shown here. There were no significant differences with respect to or concerning all cholesterols, or triglycerides observed. With respect to elevated lipoprotein (a) levels, however, the immunoadsorption method seems to be most effective. The different published data clearly demonstrate that treatment with LDL-apheresis in patients suffering from severe hyperlipidemia refractory to maximum conservative therapy is effective and safe in long-term application.
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页数:19
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