单次血脂分离术不会调节高胆固醇血症患者的脉搏波反射。
A single lipid apheresis does not modulate pulse wave reflection in hypercholesterolemic patients.
作者信息
Passauer J, Herbrig K, Fischer S, Bornstein S, Julius U
机构信息
Division of Nephrology, Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany.
出版信息
Atheroscler Suppl. 2009 Dec 29;10(5):44-8. doi: 10.1016/S1567-5688(09)71809-4.
BACKGROUND
Lipid apheresis (LA) is instituted to increase life expectancy in patients with previous cardiovascular events and severe and otherwise untreatable hypercholesterolemia. Studies have demonstrated that even a single LA markedly improves endothelial and micro-vascular function in patients. It is unknown whether these changes also impact pulse wave reflection and established parameters of arterial stiffness.
METHODS
In 20 patients on regular LA (8 treated by immunoadsorption, 7 by lipid filtration, 5 by direct adsorption of lipids) we measured peripheral blood pressure, heart rate, central systolic pressure (CSP), central pulse pressure (CPP), augmentation index (AIX) and pulse wave velocity by applanation tonometry (SphygmoCor, Atcor Medical) before and after a single treatment.
RESULTS
Peripheral blood pressure and heart rate were comparable pre- and post treatment. CSP, CPP, AIX and PWV did not significantly change during LA independent of treatment modality although LDL-cholesterol levels were markedly reduced (in average from 3.5+/-0.9 to 0.9+/-0.3 mmol/L).
CONCLUSION
The well-documented effects of a single LA on microvascular function are not associated with measurable changes in pulse wave reflection. Future studies are required in order to evaluate long-term effects of LA in this context.
背景
脂质吸附疗法（LA）旨在提高既往有心血管事件且患有严重的、无法用其他方法治疗的高胆固醇血症患者的预期寿命。研究表明，即使单次脂质吸附疗法也能显著改善患者的内皮和微血管功能。目前尚不清楚这些变化是否也会影响脉搏波反射和已确定的动脉僵硬度参数。
方法
我们对20例接受常规脂质吸附疗法的患者（8例采用免疫吸附治疗，7例采用脂质过滤治疗，5例采用脂质直接吸附治疗）在单次治疗前后，通过压平式眼压计（SphygmoCor，Atcor Medical）测量外周血压、心率、中心收缩压（CSP）、中心脉压（CPP）、增强指数（AIX）和脉搏波速度。
结果
治疗前后外周血压和心率相当。尽管低密度脂蛋白胆固醇水平显著降低（平均从3.5±0.9降至0.9±0.3 mmol/L），但脂质吸附疗法期间，无论治疗方式如何，中心收缩压、中心脉压、增强指数和脉搏波速度均无显著变化。
结论
单次脂质吸附疗法对微血管功能的显著作用与脉搏波反射的可测量变化无关。未来需要开展研究以评估脂质吸附疗法在此方面的长期效果。
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