【摘要】目的 采用新型硫酸葡聚糖(DS)血脂分离系统用于治疗高脂血症，在保证安全、有效的基础上简化血脂分离工艺，大幅度降低治疗费用。方法 选择南京医科大学第一附属医院肾内科50例患者共110例次血脂分离治疗，首先用单采机采集患者高脂血浆，按10ml/kg体重采集总量(600±100)ml。然后血浆中加入静脉注射用DS作为吸附剂，Ca2＋作为催化剂，DS特异性吸附LDL形成大颗粒，用离心法去除胆固醇、三酰甘油。结果 每次血脂分离治疗后血浆总胆固醇下降11%(6.52±0.5)和(5.8±0.4)；三酰甘油下降15%(3.85±2.1)和(3.27±1.5)；LDL-C 下降20%(4.03±0.86)和(3.2±0.52)；HDL-C保持不变(1.13±0.28)和(1.13±0.41)；白蛋白保持不变(45±5)和(45±4)，过量的Ca2＋被阳离子树脂柱完全吸附。结论 新型DS血脂分离系统工艺合理、操作过程简单、易于推广应用。特别是治疗费用低廉，更适合需要多次治疗才能纠正血脂异常的患者。

【Abstract】Objective To achieve an effective method for the treatment of hyperlipidemia at lower cost, we developed a new type of low density lipoprotein (LDL) apheresis system with dextran sulfate. Methods Fifty patients with hyperlipidemia were treated with this method in a total of 110 times. In every treatment, 600±100 ml plasma (about 25% of the total plasma of the patient) were collected by apheresis. Dextran sulfate (LDL absorbent) and calcium chloride (as a catalyzer) solution were added to the collected plasma. Dextran sulfate selectively binds LDL-cholesterol under the catalysis of Ca2+, and the LDL-cholesterol-dextran sulfate complex was removed by centrifugation. The treated plasma was then transfused back to the patient, and the excessive calcium in the plasma was removed by a cation exchange column integrated in the transfusion set. Results After every treatment, total cholesterol in plasma reduced by 11% (from 6.52±0.5 to 5.8±0.4mmol/l), triglyceride reduced by 15% (from 3.85±2.1 to 3.27±1.5mmol/l), and LDL-C reduced by 20% (from 4.03±0.86 to 3.2±0.52mmol/l). HDL-C and albumin remained unchanged. Conclusions The new LDL apheresis system with dextran sulfate is easy to operate without using complicated equipments. This method achieves significant clinical effect at a lower cost, as compared with the other available systems. It is therefore a safe, effective and cheaper measure for the treatment of hyperlipidemia.