定期脂蛋白分离术可维持晚期动脉粥样硬化疾病患者残余的心血管和微血管功能。
Regular lipoprotein apheresis maintains residual cardiovascular and microvascular function in patients with advanced atherosclerotic disease.
作者信息
Reimann M, Julius U, Bornstein S R, Fischer S, Reichmann H, Rüdiger H, Ziemssen T
机构信息
Autonomic and Neuroendocrinological Laboratory, Dept of Neurology, University Hospital Carl Gustav Carus, Dresden Fetscherstr 74, 01307 Dresden, Germany.
出版信息
Atheroscler Suppl. 2013 Jan;14(1):135-41. doi: 10.1016/j.atherosclerosissup.2012.10.009.
OBJECTIVE
To determine whether previously demonstrated beneficial short-term effects on cardiovascular function in regular users of lipoprotein apheresis would be sustainable over time.
METHODS
Regular users of lipoprotein apheresis (n = 17) were studied between February 2009 and July 2010. All patients were examined for endothelial and autonomic function at baseline and at one year of regular treatment. Microvascular function was determined by flicker-induced vasodilation of retinal vessels using the Dynamic Vessel Analyzer. Autonomic regulation of blood pressure and heart rate upon cardiovascular perturbation by deep breathing at 0.1 Hz and orthostatic challenge was evaluated by trigonometric regressive spectral analysis.
RESULTS
The acute improvement of cardiovagal function and venular endothelial function seen after a single lipoprotein apheresis was not evident at one year of regular treatment. However, baroreflex sensitivity showed an improved recovery after orthostatic challenge as compared to baseline measurements. Initially compromised autonomic and microvascular function had not further deteriorated at one year of regular lipoprotein apheresis treatment.
CONCLUSION
In patients with advanced atherosclerotic disease regular lipoprotein apheresis treatment maintains residual cardiovascular functioning over time.
目的
确定脂蛋白分离置换术的长期使用者先前表现出的对心血管功能的短期有益影响是否会随时间持续存在。
方法
在2009年2月至2010年7月期间对脂蛋白分离置换术的长期使用者（n = 17）进行了研究。所有患者在基线时以及常规治疗一年后均接受了内皮功能和自主神经功能检查。使用动态血管分析仪通过闪烁诱导视网膜血管舒张来测定微血管功能。通过三角回归频谱分析评估在0.1 Hz深呼吸和体位挑战引起心血管扰动时血压和心率的自主调节。
结果
在常规治疗一年时，单次脂蛋白分离置换术后观察到的心血管迷走神经功能和小静脉内皮功能的急性改善并不明显。然而，与基线测量相比，压力反射敏感性在体位挑战后显示出改善的恢复情况。在脂蛋白分离置换术常规治疗一年时，最初受损的自主神经和微血管功能并未进一步恶化。
结论
在晚期动脉粥样硬化疾病患者中，脂蛋白分离置换术常规治疗可长期维持残余心血管功能。
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