| Background: Dyslipidemia, consisting of elevation of serum total cholesterol, triglycerides and low-density lipoprotein cholesterol, and reduction of high-density lipoprotein cholesterol, is generally accepted to be one of potential risk factors leading to atherosclerotic diseases such as coronary artery disease (CAD) and cerebrovascular disease (CVD). Therefore, the early and active treatment of dyslipidemia is essential for prevention of the progression of CAD and CVD. In addition to diet and drug therapy, extracorporeal lipid-apheresis is now considered to be one of the most effective and promising treatments for dyslipidemia. At present, five different techniques of extracorporeal lipid-apheresis are in use: plasma exchange, double filtration plasmapheresis, immunoadsorption, chemical adsorption and heparin extracorporeal LDL precipitation system. However, the disadvantages, such as poor selectivity, high price, have been preventing their general application in the clinic. In the last two years, Shanghai Jiangxia blood Technology Co.,Ltd has introduced a new technique of extracorporeal lipid-apheresis, Delipid Extracossoseal Lipoprotein filter from Plasma system (DELP), which combines the technique of lipid filtration with adsorption. We found that DELP not only removed the TG, TC, LDL-C, FIB and other components from plasma effectively and safely, it also has such advantages as high selectivity, easy operation and low cost. Therefore, DELP is expected to generalize clinical application. It has been reported that DELP exerted remarkable therapeutic effects in the treatment of acute cerebral infarction in the multi-center randomized controlled clinical trials: it promoted patients with acute cerebral infarction early restoration of neurological function, increased the ratio of patients with good prognosis, and improved the prognosis of patients with the severely disabled. However, we still have less knowledge of DELP in treatment of refractory hyperlipidemia.Objective:In this study we tried DELP to treat the refractory hyperlipidemia patients collected in the Department of Neurology, Xijing Hospital from January 2008 to May 2009, in order to understand its efficacy and safety.Methods:This study was a self-control trial. 13 cases of refractory hyperlipidemia patients were given DELP treatment. The concentrations of TG, TC, HDL-C, LDL-C and lipoprotein composition in plasma before treatment were compared with those after treatment. Side effects were observed closely during each therapy.Results:After DELP treatment there were significant reduction of levels of TG,TC,LDL– C. Those parameters were decreased , from(13.55±8.26) mmol/ L to (7.54±4.47)mmol/ L, (7.22±2.53) mmol/ L to (4.38±1.34) mmol/ L , (3.78±1.5)mmol/ L to (2.36±0.99)mmol/ L , (0.94±0.21) mmol/ L to (0.84±0.20)mmol/ L , respectively.The levels of TG,TC and LDL-C of patients with hyperlipidemia decreased significantly by about 44 % , 39 % , 38 % respectively, with a statistic difference (P<0.05). However , the level of HDL-C decreased by about 11 % , without a statistic difference(P>0.01). There was no obvious side effect except that a patient's blood pressure declined slightly during the therapy.Conclusion: A single DELP therapy of the patients decreased plasma TG,TC, LDL-C significantly. For the patients whose plasma lipoprotein concentrations were hard to be controlled by diet and drugs, DELP significantly attenuated their lipid metabolism abnormalities,quickly prevented the artery from being damaged by dyslipidemia and facilitated the reduction of drug dosage and side effects. Taken together, DELP is an efficient and safe method to remove lipoprotein from plasma. |
