In addition to diet and medication, there are some special treatments for hyperlipidemia, such as plasma purification therapy (blood washing or blood exchange), surgical treatment and gene therapy. The former is usually the most consulted by patients. There are two main methods of plasma purification: one is plasma exchange method, i.e., taking out the patient's blood, 300 ~ 500 ml at a time, separating it, removing the plasma and the cholesterol in it, and transfusing the red blood cells, white blood cells and other components back into the body; the other is selective LDL removal method, which is more complicated, and involves the installation of a kind of specific filter inside the blood exchanger, which filters the blood, and achieves the effect of lowering cholesterol. Plasma purification therapy is indicated for those with very significant elevations in blood cholesterol and should not be used routinely for the following reasons.
(1) The effect of each treatment lasts only about 1 month, and patients need multiple treatments over a long period of time.
(2) The cost is very high and difficult for the average patient to afford.
(3) Multiple treatments may lead to infections, especially viral hepatitis and AIDS, which are not preventable.
(4) The average medical unit cannot afford to buy such a machine, so plasma purification treatment can only be used as a supplement to drug treatment.
As for the surgical treatment of hyperlipidemia, it is mainly applicable to those patients with familial hypercholesterolemia. There are three types of surgery: partial ileal resection or jejunal bypass surgery to reduce fat absorption in the small intestine; portal vena cava shunt anastomosis to reduce cholesterol synthesis; and liver transplantation.
Gene therapy is currently in the laboratory stage, and if it can be used in large numbers in the clinic, it will free many hyperlipidemic patients from the pain of long-term medication. These methods, mainly to make the blood LDL levels lower, because 50% of the weight of LDL is cholesterol.