关键词: 脂蛋白肾病, 双重血浆滤过, 载脂蛋白E, 肾活检

Abstract: Ｏｂｊｅｃｔｉｖｅ：To retrospectively observe the clinical efficacy of double fltration plasmapheresis(DFPP) in patients with lipoprotein glomerulopathy(LPG).
Ｍｅｔｈｏｄｏｌｏｇｙ：17 Patients with biopsyproven LPG  who received DFPP treatment in our center  from 2010 to 2016 were involved,clinical parameters before and after DFPP treatment were recorded and analyzed.
Ｒｅｓｕｌｔｓ：Fifteen of the patients underwent 310 courses of DFPP,and 2 patients were unable to tolerate DFPP due to allergic reactions.All patients received fenofibrate or statins and other relevant symptomatic treatments.After shortterm DFPP treatments,serum creatinine（SCr 15558±7691  μmol/L vs 13702±7337  μmol/L，P＜001）,plasma apolipoprotein E（794±187 mg/dl vs 358±132 mg/dl，P＜001）and proteinuria （468±250 g/24h vs 270±220 g/24h，P＜001），were relieved significantly.1 patient (67%) achieved complete remission of proteinuria,and 5 patients (333%) achieved partial remission of proteinuria.Four patients underwent repeated renal biopsy after DFPP treatment,and 2 of them who received 10 courses of DFPP were observed disappearment of intraglomerular lipoprotein thrombi,and negative ApoE staining.While 2 patients who  underwent only 3 and 4 courses of DFPP respectively showed no significant pathological improvement.After a median followup of 7 month（IQR 1～32）,all patients had elevated ApoE level,4 patients showed an elevation trend of SCr.Three of the four patients who had got partially or completely remission of proteinuria after DFPP tend to be stable after 12 months followup.
Ｃｏｎｃｌｕｓｉｏｎ：Shortterm efficacy of DFPP in patients with LPG was definite.However,Scr and ApoE levels rebounded in some patients during longterm followup.