免疫吸附疗法治疗高脂血症疗效观察

目的 观察低密度脂蛋白(LDL)免疫吸附疗法对高脂血症的治疗效果.方法73例高脂血症患者接受LDL免疫吸附治疗.比较1次治疗前后各项血脂指标的变化.部分病例1个月后复查血脂各项指标.总结LDL免疫吸附疗法的安全性和副作用.结果①所有患者经1次LDL免疫吸附后血甘油三脂、胆固醇和低密度脂蛋白均有明显下降(p<0.01).高密度脂蛋白略有下降(p>0.05).患者临床症状改善.②治疗后1个月复查,血脂各项指标恢复到治疗前水平(p>0.05).③3例药物治疗不能控制的乳糜微粒血症患者经LDL免疫吸附治疗后血脂明显下降,但仍达不到正常范围.其中1例治疗后继续服用原降脂药物,药物疗效较前提高.④30例患者治疗过程出现低血压.结论LDL免疫吸附能有效降低血甘油三脂、胆圃醇和低密度脂蛋白水平,对高密度蛋白无明显影响.1次治疗所能维持血脂于低水平的时间短暂.部分患者临床症状改善.低血压是主要并发症.     

血液磁极化疗法治疗高脂血症50例疗效观察

高脂血症是心、脑血管疾病的一个重要危险因素〔1〕,使血脂水平保持在正常范围,则可预防和降低冠心病的发病率和死亡率〔2〕。因此,高脂血症的治疗越来越引起人们的关注,而以往药物治疗,作用慢,时间长,且长期大量服用降脂药物,可引起肝脏损害。为此,我院应用血液磁极化治疗机,对高脂血症患者治疗,经对比观察,疗效可靠,不失为一种新的治疗手段,现总结如下:1　资料与方法1.1　对象　50例患者均有头晕、头痛、胸闷等表现,血脂检查增高,而从未采用药物降脂治疗。其中,男33例,女17例;合并高血压者11例,糖尿病6例,冠心病10例。1.2　入选标准及治疗…     

洛伐他汀治疗高脂血症120例疗效观察

目的观察洛伐他汀治疗高脂血症的疗效。方法洛伐他汀胶囊20mg-40mg,每晚饭后顿报。疗程8周。结果TC、LDL—C、TG在治疗8周后有显著下降（P〈O05）,HDL—C在8周后升高有显著性差异（P〈0.05）：120例病人用洛伐他汀治疗后,对TC的有效率89．2％（107／120）,对LDL～C的有效率855％（55／64）．对TG的有效率726％（53／73）,HDL—C的有效率为67．7％（45／65）,结论洛伐他汀降脂疗效显著,价廉,服用方便．值得基层医院推广应用.     

吉非罗齐治疗原发性高脂血症的临床疗效

观察４２例原发性高脂血症者内服吉非罗齐１２周，结果显示：血清总胆固醇（Ｔｃｈ）和甘油三酯（ＴＧ）分别下降２．２ｍｍｏｌ／Ｌ（３２％）和１．５５ｍｍｏｌ／Ｌ（６３％）．高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）上升０．３９ｍｍｏｌ／Ｌ（３６％）。治疗高甘油三酯血症、高胆固醇血症和高密度脂质缺乏症的总有效率分别为１００％、８７．５％和７２．４％。未见明显的副作用。     

活血化瘀中药治疗高脂血症30例观察

自2004年以来，我科用活血化瘀中药治疗高脂血症30例，临床疗效显著，现总结如下：     

拜斯亭治疗高脂血症42例近期疗效观察

通过观察拜斯亭对临床42例高脂血症患者的TC和TG的影响,表明拜斯亭有明显降低TC和TG的作用,总有效率分别为97.6%和67.9%.说明拜斯亭降低血脂近期疗效明显,是一种有效的降脂药.     

血栓通注射液治疗高脂血症的临床观察

高脂血症是常见病、多发病 ,它是引发心脑血管疾病的重要危险因素。为探讨血栓通注射液（有效成份为三七总皂甙 ,主要成份为人参皂甙Ｒｇ１）对血脂的影响 ,对血液流变学明显异常的患者随机分为治疗组和对照组各４０例 ,进行对比观察 ,现报告如下。资料与方法１一般资料所有病例均符合原发疾病诊断及高粘滞血症的诊断标准。治疗组４０例 ,男２８例 ,女１２例 ,年龄３８～７９岁 ,平均５１．８岁。其中冠心病１４例 ,高血压病９例 ,脑动脉硬化１７例。对照组４０例 ,男２６例 ,女１４例 ,年龄３７～８０岁 ,平均５１．１岁。其中冠心病１３例…     

血液净化治疗高脂血症

近年来有五种血液净化疗法可治疗高脂血症.血浆交换治疗技术不复杂,但要丢失高密度脂蛋白;双层过滤法可去除低密度脂蛋白、Lp(a)等,但可保留高密度脂蛋白;另三种是选择性的治疗方法:免疫吸附法、化学吸附法(硫酸葡聚糖)及肝素引导低密度脂蛋白沉淀法(HELP)进行血液净化治疗.     

通心络治疗高血压病并高脂血症的疗效观察

目的观察通心络治疗老年性高血压并高脂血症的临床疗效。方法高血压并高脂血症患者68例分为通心络治疗组36例,常规治疗组32例。治疗组在常规治疗的基础上加用通心络4粒/次,每日3次,疗程3个月￣12个月,并低脂饮食,分别在服药前一天和服药后3月及12月抽血检查,同时每周监测血压变化。对血脂、血压及总疗效评价。结果通心络治疗组降压总有效率77.8%,明显优于对照组65.5%(P<0.05);治疗组在降低TC、TG、LDL-C水平明显优于对照组(P<0.05)。结论通心络治疗高血压并高脂血症患者是安全、有效的。     

血脂康治疗高脂血症的临床观察

高脂血症是心血管疾病的重要危险因素之一。临床试验证实降低血清胆固醇(TC)及甘油三脂(TG)能预防和逆转动脉粥样硬化病变。使冠心病发病率及死亡率明显降低。本试验旨在观察血脂康胶囊的降脂疗效及副作用，现总结如下。     

Cyclophosphamide and Immunoadsorption Apheresis Treatment of Lupus Nephritis Nonresponsive to Drug Therapy Alone

In this report we present a 28-year-old male patient with systemic lupus erythematosus (SLE) that was treated with immunoadsorption apheresis (IA) and cyclophosphamide for lupus nephritis (proliferative glomerulonephritis, class IV-B) after proving nonresponsive to drug therapy alone. Before starting the therapeutic cycle with IA, the patient was administered prednisone 25 mg/d, hydroxychloroquine 200mg twice/d, ACE inhibitors 5 mg/d, aspirin 100 mg/d, furosemide 50 mg/d, and intravenous (IV) albumin (20%) 50 mL. Deteriorating clinical conditions necessitated a renal biopsy, and thereafter an increase in medication. The patient was given a bolus of IV cyclophosphamide 1 g/d for 1 day and IV methylprednisone 500 mg/d for 3 days. This was not followed by any improvement and the renal functions worsened. Thus, 3 weeks after the more aggressive pharmacologic treatment with cyclophosphamide, which had been prescribed to improve renal function, and given the young age of the patient, the decision was made to administer IA (Selesorb). IA selectively removes IgG and IgM immune complexes from the plasma, thereby reducing the complications induced by the pathogenic autoimmune reaction. The treatment was administrated twice a week for the first 15 days, once a week for a further 5 weeks, and biweekly in the last month with a bolus of cyclophosphamide (average 250-100 mg) after each session. After twelve sessions of IA over 3 months, renal function was completely restored and the patient discharged. Although it is not proven, the concomitant use of cyclophosphamide could presumably improve the final clinical outcome.     

免疫吸附技术的临床应用体会

目的　为了评价蛋白A免疫吸附和低密度脂蛋白免疫吸附对免疫球蛋白(主要为IgG)和低密度脂蛋白(LDL)的吸附作用及临床效果。方法　使用瑞典Excorim公司的Citem10吸附-洗脱环路系统,对7例自身免疫性疾病和3例高脂血症患者进行了16例次免疫吸附治疗,并将治疗前后血浆免疫球蛋白或血脂进行对比分析。结果　吸附治疗后血浆IgG、IgA、IgM均明显低于吸附前的水平(P<0.001),LDL、Lp(a)、甘油三脂、胆固醇分别下降了70.9%、53.3%、19.7%、53.0%,而高密度脂蛋白(HDL)较吸附前增高51.3%。结论　蛋白A免疫吸附和低密度脂蛋白免疫吸附可以选择性地、有效地清除血浆IgG及LDL,缓解临床症状,且未见明显副作用。     

The Number of Regulatory T Cells Correlates with Hemodynamic Improvement in Patients with Inflammatory Dilated Cardiomyopathy After Immunoadsorption Therapy

Inflammatory DCM (iDCM) may be related to autoimmune processes. An immunoadsorption (IA) has been reported to improve cardiac hemodynamics. The benefit of IA is probably related to the removal of autoantibodies. A recent study suggests additional effects of IA on the T cell–mediated immune reactions, especially on regulatory T cells (Tregs). In this prospective study, the correlation between the level of Tregs and improvement of myocardial contractility in response to IA in patients with iDCM was investigated. Patients (n = 18) with iDCM, reduced left ventricular (LV) ejection fraction (<35%), were enrolled for IA. Before and 6 months after IA, LV systolic function was assessed by echocardiography, and blood levels of Tregs were quantified by FACS analysis. Patients (n = 12) with chronic ischaemic heart failure and comparable reduced LV‐EF served as controls. IA improved LV‐EF in 12 of 18 patients at 6‐month follow‐up. These patients were classified as ‘IA responder’. In 6 patients, LV‐EF remained unchanged. At baseline, IA responder and non‐responder subgroups showed similar values for C‐reactive protein, white blood cells, lymphocytes and T helper cells, but they differ for the number of circulating Tregs (responder: 2.32 ± 1.38% versus non‐responder: 4.86 ± 0.28%; P < 0.01). Tregs increased significantly in the IA responders, but remained unchanged in the IA non‐responders. In patients with ischaemic cardiomyopathy, none of these values changed over time. A low level of Tregs in patients with chronic iDCM may characterize a subset of patients who do best respond to IA therapy.     

Effect of oxidized LDL on hemolytic resistance of erythrocyte

Using the method of peroxide-induced chemiluminescence we showed that incubation of the whole blood with oxidized LDL or oxidized blood plasma increased plasma hemoglobin concentration, which linearly depended on the degree of LDL oxidation. Similar effects were observed in erythrocyte suspension. Hemolytic activity of oxidized plasma 3-4-fold surpassed that of LDL isolated by ultracentrifugation. LDL capacity to oxidation in the presence of Cu²⁺ increased by 50% and osmotic hemolysis of erythrocytes increased by 53% in coronary patients in comparison with healthy donors. These results indicate that oxidized LDL induce erythrocyte hemolysis.     

认知行为疗法对失眠症疗效的影响

目的观察认知行为疗法（CBT）对失眠症患者睡眠质量和心理健康水平疗效的影响。方法选择符合CCMD-3的失眠症患者72例,药物组36例,服用佐匹克隆,联合治疗组36例,以佐匹克隆合并认知行为疗法治疗,共治疗8周,治疗前后分别用症状自评量表（SCL-90）评价心理健康水平,用匹兹堡睡眠质量指数（PSQI）评定临床疗效。结果治疗结束后,比较药物组和联合治疗组SCL-90评分躯体化（t=2.682,P〈0.01）、人际关系敏感（t=2.685,P〈0.01）、强迫症状（t=2.983,P〈0.01）、抑郁（t=2.045,P〈0.05）、焦虑（t=2.650,P〈0.01）,联合治疗组评分明显低于药物组;匹兹堡睡眠质量（t=2.366,P〈0.05）、入睡时间（t=2.398,P〈0.05）、睡眠效率（t=2.176,P〈0.05）、睡眠药物（t=2.060,P〈0.05）,各因子联合治疗组得分明显低于药物组。结论认知行为疗法可提高失眠症患者的心理健康水平,改善患者睡眠质量和情绪症状,减少药物不良反应。     

阿托伐他汀对高脂血症患者血压的影响

目的 观察阿托伐他汀对高脂血症患者血压的影响.方法 选择高血压病1级、低或中度危险组的患者27例,口服阿托伐他汀10mg/d,共2周,观察治疗前后收缩压、舒张压、血脂水平、体重的变化.结果 治疗前后收缩压(SBP)明显降低(147.85±5.75 mmHg VS 143.74±6.02 mmHg,p<0.05);舒张压无明显改变(91.52±6.18mmHg VS 91.04±5.95 mmHg,p>0.05),治疗前后血脂无明显变化:TC(5.94±0.58mmol/L VS 5.90±0.51mmol/L,p>0.05)、LDL-TC(3.28±0.36mmol/L VS 3.25±0.32mmol/L,p>0.05)、HDL-TC(0.89±0.24mmol/L VS 0.90±0.22mmol/Lp>0.05)、TG (1.58±0.33mmol/L VS 1.57±0.26mmol/Lp>0.05),治疗前后体重无明显变化(75.07±5.09kg VS 74.95±4.96kg,p>0.05).结论 在血脂水平、体重下降前,收缩压已有明显下降,而舒张压下降不明显,说明阿托伐他汀对血压的影响独立于调整血脂作用之外.