In recent years, the incidence of hyperlipidemia acute pancreatitis (HLAP) has been increasing year by year, but its pathogenesis has not been completely clear. There are many clinical treatment methods for HLAP, such as lipid-lowering drugs, low molecular weight heparin, insulin, and plasma exchange. Actively reducing serum triglyceride is the core of treatment. Plasma exchange can quickly and effectively reduce the level of triglyceride, and its application in the treatment of HLAP is gradually increasing. This article reviews the recent advances in the pathogenesis, clinical characteristics, diagnosis, and treatment of HLAP, focusing on the mechanism, indications, timing, and disadvantages of plasma exchange therapy for HLAP.
Objective To study the clinical protective effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis (HLSAP). Methods Thirty-seven patients with HLSAP treated between January 2012 and December 2014 were selected and divided into three groups based on different treatments. Thirteen patients were allocated into hemoperfusion combined with continuous veno-venous hemofiltration group (HP+CVVH group) and treated with hemoperfusion combined with hemofiltration; 11 patients were allocated into continuous veno-venous hemofiltration group (CVVH group) and treated with hemofiltration; and all the other patients were allocated into control group and treated with conventional treatment. The levels of blood triglyceride, C-reactive protein, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) and acute physiology and chronic health evaluation (APACHE)Ⅱ score of the patients after treatment were observed. The hospital stay, organ dysfunction rate and mortality of the patients were measured. Results Compared with the control group, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group and CVVH group were both significantly reduced 72 hours after therapy (P<0.05). However, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group were significantly lower than those in the CVVH group at the same time point (P<0.05). The hospital stay of the patients in the HP+CVVH group and CVVH group was significantly shorter than that in the control group (P<0.05). Compared with the CVVH group, the hospital stay of patients in the HP+CVVH group was significantly shorter (P<0.05). There was no statistical difference in organ dysfunction rate and mortality among the three groups (P>0.05). Conclusion Hemoperfusion combined with hemofiltration is an effective method for HLSAP by cleaning the inflammatory mediators availably and inhibiting the excessive inflammatory reaction.
ObjectTo observe the clinical efficacy and safety of the combination therapy of atorvastatin and JiangZhi Decoction (ZJD) for primary hyperlipidemia (Tan Zhuo Zu E Zheng) and to analyze the interactions of drugs in hypolipidemic effect. MethodsA 2*2 factorial design, single-blind, stratified randomized controlled trial according to the level of lipid was conducted. Primary hyperlipidemia (Tan Zhuo Zu E Zheng) patients met the inclusion criteria were divided into 5 groups:ATV 10 mg group (group A), ATV 20 mg group (group B), ATV 10 mg+JZD group (group C), ATV 20 mg+JZD group (group D), JZD group (group E). After two weeks treatment, the efficacy and safety among the 5 groups were compared. ResultsA total of 92 patients were included, of which, 20 were in group A, 25 in group B, 21 in group C, 17 in group D, and 9 in group E. The results showed that:(1) There was no significant difference between group C and group B in the reduction of serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (PTC=0.226, PLDL-C=0.818). (2) The results of 2*2 factorial analysis showed that, there was no significant interaction between TCM factor and western medicine factor (PTC=0.605, PLDL-C=0.843). (3) There were no significant differences in safety outcomes among 5 groups (all P values >0.05). ConclusionATV 10 mg+JZD and ATV 20 mg have a similar efficacy in reducing TC and LDL-C. There is no obvious interaction between JZD and ATV in hypolipidemic effect, and the combination therapy of ATV and JZD is safe.
ObjectiveTo systematically review the efficacy and safety of electroacupuncture in animal hyperlipidemia models. MethodsDatabases such as CNKI, WanFang Data, VIP, CBM, PubMed, EMbase and The Cochrane Library (Issue 12, 2013) were searched for studies concerning the efficacy and safety of electroacupuncture in animal hyperlipidemia models up to December 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies by using reformative CAMARADES List. Then, meta-analysis was performed by using RevMan 5.2 software. ResultsA total of 4 studies involving 89 rats were included. The average score of CAMARADES List was 4. The results of meta-analysis showed that:there were no significant differences between electroacupuncture group and medication group in reducing the levels of TC (MD=0.06, 95%CI -0.08 to 0.20, P=0.40), TG (MD=-0.01, 95%CI -0.08 to 0.06, P=0.74), LDL-C (MD=0.01, 95%CI -0.04 to 0.03, P=0.65) and increasing the level of HDL-C (MD=-0.00, 95%CI -0.09 to 0.08, P=0.93). ConclusionCurrent evidence shows that there are no differences between electroacupuncture and medication in reducing levels of TC, TG, LDL-C and increasing the level of HDL-C in hyperlipidaemia rats. But due to the limitation of sample size of included studies, more large-scale, high quality studies are needed.
Objective To investigate the relationship between dyslipidemia and diabetic retinopathy in non-insulin-dependent diabetes mellitus（NIDDM） patients． Methods In 55 health controls，60 NIDDM patients with DR and 75 NIDDM patients without DR，the plasma total cholesterol（TC），triglycerides（TG），high-density lipoprotein（HDL）and HDL subfractions，fasting plasma glucose（FPG），fasting plasma insulin（FINS）and glycosylated hemogolbin（HbA 1C）were measured，and the plasma lowdensity lipoprotein （LDL） and very lowdensity lipoprotein（VLDL）were caculated． Results In NIDDM patients with DR，the TC，LDL，FPG，HbA 1C and duration of NIDDM were higher or longer than those in NIDDM patients without DR．Moreover，the TC，LDL，FPG、FINS、HbA 1C and dutation of NIDDM were increased or lengthened in NIDDM patients with proliferative DR as compared with those with backgroud DR．The correlation analysis showed the severity of DR was positively correlated with TC，LDL，HbA 1C and duration of NIDDM． Conclusion Dyslipidemia may play some role in the onset and development of DR． (Chin J Ocul Fundus Dis,1998,14:21-23)
目的:探讨普罗布考对动脉粥样硬化性脑梗死并高脂血症患者血脂及预后的影响。方法:将87例脑梗死并高脂血症患者随机分为两组,治疗组44例,对照组43例,两组除按动脉粥样硬化性脑梗死常规治疗外,停用一切降脂药物。治疗组给予普罗布考500mg bid/d。疗程为6个月。随访一年观察两组患者治疗后血脂水平及脑血管事件发生情况。结果:治疗组患者治疗前、后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)间差异均有显著性意义(Plt;0.05)。两组患者治疗后各项血脂指标间差异均有显著性意义(Plt;0.05)。随访一年,显示治疗组患者心脑血管事件14次,对照组19次(Plt;0.05)。结论:普罗布考降脂疗效可靠、副作用轻微,降低心脑血管事件发生。可作为动脉粥样硬化性脑梗死并高脂血症患者的一、二级预防药物。