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首页> 外文期刊>Current opinion in lipidology >Safety and effectiveness of long-term LDL-apheresis in patients at high risk.
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Safety and effectiveness of long-term LDL-apheresis in patients at high risk.

机译：高危患者长期LDL置换的安全性和有效性。

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摘要

Since its introduction more than 10 years ago, LDL-apheresis has gained much interest and has proven its clinical utility in patients who cannot be adequately treated by diet and drug therapy alone. A number of clinical studies have clearly demonstrated that regular LDL-apheresis not only favourably influences the progression of coronary artery disease, but also decreases the incidence of cardiovascular events and prolongs survival time of coronary patients at high risk. Both hypercholesterolemia and hyperfibrinogenemia show a high prevalence in heart transplant recipients and seem to cause direct effects on survival time. Heparin-mediated extracorporeal LDL-precipitation-LDL-apheresis has proven to be very successful in this group of patients, which may be caused by the simultaneous removal of LDL, lipoprotein (a) and fibrinogen, and also because LDL-apheresis decreases the susceptibility of LDL to oxidation. In addition, there is clear clinical and experimental evidence that LDL-apheresis rapidly improves the endothelial-mediated vasomotion. Not unexpectedly, there are differences in specificity and side-effects between the systems used and these deserve more attention for future routine clinical use.
机译：自从10多年前推出以来，LDL-apheresis引起了人们的极大兴趣，并证明了其在不能单独通过饮食和药物治疗得到充分治疗的患者中的临床实用性。许多临床研究清楚地表明，定期进行LDL置换不仅有利地影响了冠状动脉疾病的进展，而且还降低了心血管事件的发生率并延长了高危冠心病患者的生存时间。高胆固醇血症和高纤维蛋白原血症在心脏移植受者中均显示很高的患病率，并且似乎直接影响生存时间。肝素介导的体外LDL沉淀-LDL置换在该组患者中非常成功，这可能是由于同时去除LDL，脂蛋白（a）和纤维蛋白原以及LDL置换降低了敏感性LDL氧化。此外，有明确的临床和实验证据表明，LDL置换可迅速改善内皮介导的血管舒张。毫不意外的是，所用系统之间的特异性和副作用有所不同，这些对于将来的常规临床应用应引起更多关注。

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