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目的探讨影响血浆置换治疗高脂血症疗效的相关因素。方法 63例高脂血症患者均行血浆置换治疗,记录治疗后血清三酰甘油(triacylglycerol,TG)下降幅度,并依据血清TG下降幅度将63例患者分为2组,比较2组年龄、体质量指数(body mass index,BMI)及血浆置换前TG、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、红细胞压积(hematocrit,HCT)、总血容量(total blood volume,TBV)、循环量、置换去除血浆量、血浆置换时间差异,Pearson相关分析影响TG降幅的因素。结果 63例患者血浆置换治疗前TG水平为9.05~39.48mmol/L,治疗后为1.16~18.63mmol/L,TG降幅40.32%~94.75%,其中TG降幅40.32%~70.00%者24例为TG下降轻微组,TG降幅>70.00%~94.75%者39例为TG下降明显组;TG下降轻微组年龄[(50.50±5.22)岁]较TG下降明显组大[(46.33±4.86)岁](P<0.05),血浆置换时间[(91.50±7.81)min]较TG下降明显组长[(80.38±6.75)min](P<0.015),BMI[(22.81±2.67)kg/m2]及血浆置换治疗前TG[(18.70±0.98)mmol/L]、TC[(6.75±0.66)mmol/L]、LDL-C[(1.48±0.11)mmol/L]、TBV[(4 259.83±292.77)mL]、循环量[(4 741.67±202.50)mL]、置换去除血浆量[(1 683.33±90.59)mL]均低于TG下降明显组[BMI(26.05±2.79)kg/m2、TG(22.89±1.08)mmol/L、TC(9.32±0.71)mmol/L、LDL-C(1.92±0.13)mmol/L、TBV(4 983.37±304.65)mL、循环量(4 893.75±217.64)mL、置换去除血浆量(1 775.00±93.84)mL](P<0.01);Pearson相关分析结果显示,TG降幅与血浆置换前TG(r=0.695,P=0.000)、TC(r=0.506,P=0.007)、LDL-C(r=0.454,P=0.009)、BMI(r=0.375,P=0.017)、TBV(r=0.413,P=0.013)、循环量(r=0.271,P=0.041)、置换去除血浆量(r=0.343,P=0.021)呈正相关,与年龄(r=-0.298,P=0.034)、血浆置换时间(r=-0.388,P=0.016)呈负相关。结论血浆置换前TG、TC、LDL-C及BMI、TBV、循环量、置换去除血浆量、年龄、血浆置换时间是影响血浆置换治疗高脂血症疗效的相关因素。
Objective To investigate the factors influencing the efficacy of plasma exchange in the treatment of hyperlipidemia. Methods Sixty-three patients with hyperlipidemia were treated with plasma exchange. The decrease of serum triglyceride (TG) was recorded. Sixty-three patients were divided into two groups according to the decrease of serum TG. Two groups of age, Body mass index (BMI), plasma TG, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), hematocrit (HCT) Total blood volume (TBV), circulating volume, plasma volume of plasma exchange, plasma exchange time difference, and Pearson correlation analysis were used to analyze the factors influencing TG decline. Results The plasma TG levels before treatment in 63 patients were 9.05-39.48mmol / L, after treatment, they were 1.16-18.63mmol / L, TG decreased 40.32% -94.75%, TG decreased 40.32% -70.00%, TG decreased In the mild group, TG decreased more than 70.00% -94.75% in 39 cases, and decreased significantly in TG group (P <0.05); TG decreased significantly in the mild group [(50.50 ± 5.22) years vs [46.33 ± 4.86 years] (P <0.015), BMI [(22.81 ± 2.67) kg / m2], and plasma exchange time before [(91.50 ± 7.81) min] TG [(18.70 ± 0.98) mmol / L], TC [(6.75 ± 0.66) mmol / L], LDL- C [1.48 ± 0.11 mmol / L] and TBV [(4 259.83 ± 292.77) mL] (P <0.05), and the plasma volume of plasma was (7441.67 ± 202.50) mL and the volume of blood plasma was significantly lower than that of the control group [(26.05 ± 2.79) kg / m2 and TG (22.89 ± 1.08) mmol / L, TC (9.32 ± 0.71) mmol / L, LDL-C (1.92 ± 0.13) mmol / L and TBV (9883.37 ± 304.65) mL and circulation ± 93.84) mL] (P <0.01). The Pearson correlation analysis showed that the decrease of TG was positively correlated with the level of TG (r = 0.695, P = 0.000) = 0.454, P = 0.009), BMI (r = 0. (R = 0.343, P = 0.017), TBV (r = 0.413, P = 0.013), circulating volume (r = 0.271, P = 0.041) = -0.298, P = 0.034), plasma exchange time (r = -0.388, P = 0.016) was negatively correlated. Conclusions The plasma levels of TG, TC, LDL-C, BMI, TBV, circulating volume, plasma volume, age and plasma exchange time before plasmapheresis are the related factors that influence the efficacy of plasmapheresis in the treatment of hyperlipidemia.