摘要
目的:通过观察双重血浆置换(DFPP)在难治性高脂血症中的作用,评估其临床应用的安全性及有效性。方法:回顾性分析2016年1月至2020年6月于南京医科大学第二附属医院肾脏病中心因难治性高脂血症行DFPP治疗患者的效果及安全性,主要观察DFPP治疗前后血清三酰甘油、总胆固醇、血小板、纤维蛋白原、免疫球蛋白、白蛋白等的变化。结果:11例难治性高脂血症患者(男性9例、女性2例,平均年龄44.0±3.0岁)行DFPP总计25例次,其首发病分别为急性胰腺炎5例(45.5%),2型糖尿病3例(27.3%),膜性肾病、家族遗传性高脂血症、妊娠状态各1例(9.1%)。单次DFPP治疗可以快速降低血脂水平,三酰甘油由28.5±5.2 mmol/L降至9.6±1.7 mmol/L(P<0.01,下降率61.2%±16.2%);同时总胆固醇、低密度脂蛋白均显著下降,下降率分别为50.8%±15.2%和44.5%±21.8%(P均<0.01)。DFPP对血清白蛋白、免疫球蛋白IgG、血小板的水平无明显影响。25例次DFPP治疗均顺利完成,治疗期间无明显不良反应。结论:DFPP能快速降低难治性高脂血症患者的胆固醇和三酰甘油水平,安全性高,但临床推广仍需要随机对照临床研究进一步验证。
Objective:The aim of this study was to clarify the efficacy and safety of double filtration plasmapheresis(DFPP)in refractory hyperlipidemia.Methodology:Patients who received DFPP due to refractory hyperlipidemia from January 2016 to June 2020 in Center for Kidney Disease,2 nd Affiliated Hospital of Nanjing Medical University were analyzed retrospectively.The efficacy and safety of DFPP were evaluated.Serum triglycerides(TG),total cholesterol(TC),platelets,fibrinogen,immunoglobulin and serum albumin were monitored.Results:11 patients with refractory hyperlipidemia(male:femal 9:2,average age of 44.0±3.0 years)received DFPP for 25 sessions.Major diseases of them were acute pancreatitis(5 cases)(45.5%),type 2 diabetes(3 cases)(27.3%),membrane nephropathy/familial hyperlipidemia/pregnancy status(1 case for each)(9.1%).After single DFPP,TG dropped from 28.5±5.2 mmol/L to 9.6±1.7 mmol/L(reduction rate 61.2%±16.2%).TC and low-density lipoprotein decreased rapidly with the reduction rates 50.8%±15.2%and 44.5%±21.8%,respectively.There were no significant changes of serum albumin,IgG or platelet after DFPP.There was no adverse reaction during DFPP in this study.Conclusion:The preliminary study proved the efficacy and safety of DFPP in refractory hyperlipidemia.Howerever,the application of DFPP in refractory hyperlipidemia still needs further studies.
作者
魏桂玲
叶红
石彩凤
陶玲
许方方
曹红娣
杨俊伟
WEI Guiling;YE Hong;SHI Caifeng;TAO Ling;XU Fangfang;CAO Hongdi;YANG Junwei(Center for Kidney Disease,2^(nd) Affiliated Hospital,Nanjing Medical University,Nanjing,210003,China)
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2021年第4期332-336,共5页
Chinese Journal of Nephrology,Dialysis & Transplantation
基金
国家自然科学基金(81800653)。
关键词
难治性高脂血症
双重血浆置换
治疗
hyperlipidemia
double filtration plasmapheresis
therapy
