离心式血浆分离联合血浆吸附法降低高血脂的效果分析

Centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia:A clinical observation of 42 cases

目的探究离心式血浆分离联合血浆吸附治疗高脂血症的临床疗效及安全性。方法 2019年2月~2020年10月期间的高脂血症患者病例42例,采用全自动离心式血浆分离联合血浆吸附法去除高血脂,以枸橼酸钠作为抗凝剂,全血流速(30~80) mL/min,血浆循环容量2 500 mL,治疗时间2 h,弃浆200 mL,每2周治疗1次,共治疗2次,6周后评估疗效;检测治疗前后的血清总蛋白、血脂谱和血液流变学指标,并观察治疗期间不良反应。结果 42例患者治疗后的总有效率为95.24%,治疗后TP、TC、TG和LDL-C值(74.26±5.91、3.88±1.06、2.20±1.13、3.17±0.85)均较治疗前(82.53±6.37、7.46±1.83、5.91±2.16、4.23±1.02)明显降低(P<0.05),而HDL-C值(1.23±0.26)较治疗前(0.92±0.15)明显升高(P<0.05);治疗后全血高切黏度、全血低切黏度、血浆黏度、红细胞压积及纤维蛋白原水平(5.16±0.88、12.04±2.32、1.68±0.29、32.53±4.42、3.14±0.45)均较治疗前(7.53±1.21、18.27±3.15、2.46±0.37、52.24±5.31、4.28±0.76)明显降低(P<0.05);治疗过程中不良反应发生率为14.3%,未见严重不良反应。结论离心式血浆分离联合血浆吸附法应用于高血脂患者的治疗安全有效。

Objective To investigate the clinical efficacy and safety of centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia.Methods The data of 42 patients with hypertriglyceridemia from February 2019 to October 2020 were retrospectively collected and analyzed.The patients were treated with plasma component exchange by centrifugal plasma separation combined with plasma adsorption(PA)lipid-lowering therapy.The plasma was separated by an automatic blood cell separator,and was then adsorbed by membrane plasma component absorber.Conditions for plasma component exchange were sodium citrate as anticoagulant,the whole blood flow rate at(30~80)mL/min,the plasma circulation volume 2500 mL,the treatment time 2 h,and the discarded plasma 200 mL.The treatment was performed once every two weeks,twice in total,and the efficacy was evaluated 6 weeks later.The changes of serum total protein(TP),blood lipid indexes and hemorheology indexes before and after treatment were observed,and the adverse reactions during treatment were recorded.Results The effective rate of 42 patients after treatment was 95.24%.The values of TP,TC,TG and LDL-C decreased significantly(82.53±6.37 vs 74.26±5.91,7.46±1.83 vs 3.88±1.06,5.91±2.16 vs 2.20±1.13,4.23±1.02 vs 3.17±0.85)while HDL-C increased significantly(0.92±0.15 vs 1.23±0.26)after the treatment(P<0.05).After the treatment,the levels of whole blood high-cut viscosity,whole blood low-cut viscosity,plasma viscosity,hematocrit and fibrinogen decreased significantly(7.53±1.21 vs 5.16±0.88,18.27±3.15 vs 12.04±2.32,2.46±0.37 vs 1.68±0.29,52.24±5.31 vs 32.53±4.42,4.28±0.76 vs 3.14±0.45)(P<0.05).The incidence of adverse reactions was 14.3%,and no serious adverse reactions were observed.Conclusion The centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia is safe and effective.