背景和目地：當血中三酸甘油脂濃度大於1000mg/dl 時，即有可能併發胰臟炎之危險。本研究計畫評估血漿交換治療對血中三酸甘油脂濃度大於1000mg/d 且合併急性胰臟炎之高脂血性胰臟炎血中物質之清除效果。方法：8 例高脂血性胰臟炎，接受每天一次，連續兩天之血漿交換治療。結果：單次血漿交換治療下三酸甘油脂、膽固醇、澱粉酵素及解脂酵素之平均清除率分別為63.0%，53.7%，62.9% 及68.8%。連續兩次治療下之平均清除率可增加至83.3%，62.9%，79.6% 及80.4%。在第一次血漿交換後，除一例外，其餘7 例皆已降至1000mg/dl 以下。在全部16 次血漿交換治療中有2 次因穿膜壓過高引發溶血現象。併發症部分，輸注新鮮冷凍血漿之7 例中除一例(個案4) 外皆出現輸液相關併發症，其中畏寒出現3 次，出現8 次不適反應。三酸甘油脂及膽固醇之清除率分別與該物質治療前濃度成正相關(分別為p=0.0238 及p=0.0117)。開始血漿交換治療天數與解脂酵素及澱粉酵素清除率皆呈有意義負相關(分別為p=0.0062 及p=0.0413)。結論：對大部份高脂血性胰臟炎病人而言單次血漿交換應足已清除大部份之血中致病物質。另外，早期血漿交換治療有助於胰臟酵素之清除。血漿交換輸液部份，如無凝血障礙之考量，白蛋白溶液為較安全之輸液。

Backgroud and Purpose: Patientswith triglyceride levels over 1000mg/dl are at highrisk of developing acute pancreatitis. This study aimed to determine the effectiveness ofplasma exchange (PE) in reducing triglyceride levels during an acute attack ofhyperlipidemic pancreatitis (HLP). Methods: A total of 8 hypertriglyceridemic patientswith the complication of acute pancreatitis received one course of PE treatment for 2consecutive daily sessions. Results: The respective mean removal rates during a single PEfor triglyceride, cholesterol, amylase, and lipase were 63.0%, 53.7%, 62.9%, and 68.8%,respectively. An additional one exchange increased the removal rate to 83.3%, 62.9%,79.6%, and 80.4%, respectively. The triglyceride level dropped to below 1000 mg/dl in allbut one after the first PE treatment. Hemolysis during PE was found in 2 out of total 16sessions due to high transmembrane pressure. Regarding the PE-related complicationsusing fresh frozen plasma as replacement fluid, eight events occurred. The clearance ratesof triglyceride and cholesterol were significantly higher for baseline triglyceride level(p=0.0238) and baseline cholesterol level (p=0.0117), respectively. The earlier start of PEtreatment correlated well the clearance of lipase and amylase (p=0.0062 and p=0.0413,correspondingly). Conclusion: A single PE treatment is an effective method to clearimpurities from plasma for most HLP patients. Earlier start of PE treatment may providemore effective removal of pancreatic enzymes from the plasma. As compared to freshfrozen plasma, albumin solution seems to be the more safer replacement fluid used in thePE unless the coexistent coagulopathy is highly concerned.