Hyperlipidemia refers to the increase of serum lipids to a certain state. Generally speaking, hyperlipidemia refers to the increase of blood cholesterol above 220mg / dL or triglyceride above 150mg / dl. The causes of hyperlipidemia include genetic factors, dietary factors and secondary factors. In recent years, hyperlipidemia has increased significantly in all countries. Hyperlipidemia is known as an asymptomatic disease. Only when the blood viscosity is significantly increased, can symptoms occur. However, as a kind of disease with continuous development, people have paid attention to it, such as arteriosclerosis. In addition, hyperlipidemia has a significant effect on the end circulation of kidney, pancreas, pruritus, immunity (inhibition), blood coagulation and so on. Hyperlipidemia, especially hypercholesterolemia and hypertriglyceridemia, is one of the important risk factors for arteriosclerosis. The treatment of hyperlipidemia usually adopts diet therapy and drug therapy. Recently, many drugs have been developed to improve hyperlipidemia. But according to the different conditions, patients may appear drug resistance, because there is no response to drug treatment, now generally use the principle of adsorption or molecular filtration to remove the lipids in the blood, which is called lipid purification. This treatment has definite clinical effect on correcting hyperlipidemia, reducing the degree of arteriosclerosis and improving circulation. It is generally believed that strong plasma lipid purification is more necessary for the prevention of atherosclerosis than for the treatment.
Blood purification system as an effective treatment has been widely concerned. At present, the blood purification technologies related to lipid clearance are used at home and abroad, including total plasma exchange therapy, double membrane filtration separation, frozen coagulation filtration, immune adsorption, etc. However, because of the shortage of plasma, high price and complex operation, the above-mentioned methods are limited to be widely used in China. Blood perfusion is to lead blood out of the body, through the perfusion device equipped with adsorption materials, through the adsorption of blood lipids, the effect is accurate, the operation is simple, the price is reasonable, widely recognized by the clinical.
Liang Yan, Wang Zongqian [1] reported that 36 patients with hyperlipidemia were treated with Jianfan ha hemoperfusion device. After hemoperfusion, the total cholesterol, triglyceride, low-density lipoprotein cholesterol and fibrinogen were significantly lower than those before hemoperfusion, which showed that hemoperfusion had a significant therapeutic effect on hyperlipidemia, and it was one of the effective methods to treat hyperlipidemia. Li Li, Zhang Weiqing, et al. [2] selected 32 patients with Refractory Hyperlipidemia to be treated with HA hemoperfusion, and measured the levels of total cholesterol, triacylglycerol, low-density lipoprotein and high-density lipoprotein before and after hemoperfusion. Results the levels of total cholesterol, triglyceride and low-density lipoprotein after hemoperfusion were lower than those before treatment, and there was no significant difference in the levels of high-density lipoprotein before and after treatment. There were 5 cases of adverse reactions in 32 patients, including 3 cases of blood pressure drop, 1 case of palpitation, 1 case of shortness of breath, 1 case of chest distress, 1 case of shivering. After treatment, it was relieved without interruption of treatment. Conclusion: hemoperfusion is a safe and effective method in the treatment of Refractory Hyperlipidemia. It can obviously improve the biochemical indexes of blood lipids and reduce the cardiovascular risk factors. It is worth popularizing and applying in the primary hospital. Guo Shuling and Liu Bo [3] reported that 28 patients with refractory hyperlipidemia were treated with HA hemoperfusion for 120 minutes, and the levels of total cholesterol, triacylglycerol, low-density lipoprotein and high-density lipoprotein were measured before and after hemoperfusion. Results: after hemoperfusion, all the indexes of blood lipid in the plasma were decreased, which were cholesterol 21.8%, triacylglycerol 45.7%, high density lipoprotein 16.5%, low density lipoprotein 20.5%, especially triacylglycerol. Conclusion: hemoperfusion is a safe and effective method in the treatment of Refractory Hyperlipidemia, and has obvious short-term effect.
The HA hemoperfusion resin is styrene divinylbenzene polymer, which can adsorb hydrophobic lipophilic groups or middle and large molecular substances with benzene ring structure through three-dimensional mesh molecular sieve, van der Waals force and lipophilic and water releasing bond. The mechanism of hemoperfusion in the treatment of hyperlipidemia is that the particle size of blood lipid falls within the range of the pore size of the adsorbent in the hemoperfusion device, and it can be compatible with lipid substances through van der Waals force, lipophilic and hydrophobic properties, etc. Hemoperfusion treatment of hyperlipidemia can significantly improve the biochemical indicators of blood lipids, reduce cardiovascular risk factors, is a safe and effective method, worthy of clinical promotion.
reference:
[1] Liang Yan, Wang Zongqian. Clinical observation on 36 cases of hyperlipidemia treated by hemoperfusion [J]. Chinese Journal of arteriosclerosis, 2012,20 (2): 169-171
[2] Li Li, Zhang Weiqing et al. Observation on the clinical efficacy of hemoperfusion in the treatment of Refractory Hyperlipidemia [J]. Chinese general medicine, 2012,15 (8): 2819-2820
[3] Guo Shuling, Liu Bo. Observation on the therapeutic effect of hemoperfusion in the treatment of Refractory Hyperlipidemia [J]. Chinese Journal of Nephrology with integrated traditional and Western medicine, 2007,8 (8): 482-483
Filing: Liu Xiaohong
Editor: Su Biying