Пересадка печени

В течение более чем 6 недель после операции концентрация холестерола в крови девочки держалась на уровне 3 мг/мл, тогда как прежде она составляла 12 мг/мл. Безусловно, пересадка печени вовсе не идеальный способ лечения, но полученные результаты убедительно показывают, что рецепторы клеток трансплантированной печени сохраняют свою активность и успешно удаляют ЛНП из циркуляции.

Но как обстоит дело с теми многочисленными случаями инфаркта и инсульта, когда больной не имеет генетических дефектов, затрагивающих рецепторы ЛНП? Имеет ли какое-либо отношение то, что мы узнали о рецепторах ЛНП, к высокой частоте атеросклероза у населения в целом? Мы думаем, да: в большинстве случаев

атеросклероз развивается из-за опасно высокого уровня ЛИП в крови, который лото, что продуцируют недостаточно рецепторов ЛНП. Причиной неадекватного количества рецепторов ЛНП могут быть тонкие генетические факторы и факторы окружающей среды, которые ограничивают образование рецепторов ЛНП даже у людей, не больных семейной гиперхолестеролемией. Олнн из таких внешних факторов — потребление большого количества холестерола и насыщенных жиров, источником которых служит мясная пища.

Результаты эпидемиологических исследований в разных странах за последние 30 лет, говорят о том, что проблема атеросклероза в данной популяции тем серьезнее, чем выше в этой популяции средний уровень ЛНП в крови. А. Кейс из Медицинской школы Миннесотского университета еще в 1958 г. исследовал в семи странах популяции с различной средней общей концентрацией холестерола в крови — от высокой (2,65 мг/мл) до низкой (1,6 мг/мл). (Он определял суммарный холестерол, а не холестерол ЛНП, но, поскольку содержание прочих липопротеинов варьирует слабо, можно считать, что различия в концентрации холестерола отражают различия в содержании ЛНП.) Кейс зарегистрировал уровень холестерола в крови у 12 763 молодых мужчин и спустя 10 лет выяснял, у кого из них случались сердечные приступы.

 

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