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目的 了解高胆固醇血症患者经调脂治疗后 ,达到国内《血脂异常防治建议》要求的总胆固醇与低密度脂蛋白胆固醇治疗目标的比例。方法 选择已接受同一调脂药物治疗至少 2个月的高胆固醇血症患者 ,测定其血脂水平 ,判断是否达到治疗目标。同时记录患者的心血管病危险因子以及调脂治疗的药物名称。结果 共入选 180例患者 ,平均年龄 6 5 .8岁。其中 6 .7%的患者无危险因子也无明确的动脉粥样硬化疾病 (低危组 ) ,6 5 .5 %的患者有危险因子但无明确的动脉粥样硬化疾病 (高危组 ) ,2 7.8%的患者有明确的动脉粥样硬化疾病或糖尿病。在整个人群中 ,仅有 4 4 %患者的总胆固醇与低密度脂蛋白胆固醇水平同时达到治疗目标。低危组与高危组患者的达标率高于动脉粥样硬化疾病与糖尿病组。对 4种不同调脂药物与达标率的关系也进行了研究 :辛伐他汀组为 5 1.8% ,普伐他汀组为 4 2 .9% ,氟伐他汀组为 31.6 % ,其他药物组为 12 .5 %。结论 超过一半正在接受调脂治疗的患者 ,其总胆固醇与低密度脂蛋白胆固醇水平并未达到治疗目标。调查表明在《血脂异常防治建议》与临床实践之间仍然存在一定差距 ,提示需要更积极的调脂治疗。
Objective To understand the proportion of patients with hypercholesterolemia after lipid-lowering treatment and achieve the goal of “the prevention and treatment of dyslipidemia” required by the guidelines for total cholesterol and low-density lipoprotein cholesterol in China. Methods Patients with hypercholesterolemia who had been treated with the same lipid-lowering drug for at least 2 months were enrolled in the study. Their blood lipid levels were measured to determine if the treatment targets were met. At the same time, the patient’s cardiovascular risk factors and the drug name of the lipid-lowering treatment were recorded. Results A total of 180 patients were selected, with an average age of 65.8 years. Sixty-seven percent of patients had no definite atherosclerotic disease without risk factors (low-risk group), 65.5% had risk factors but no definite atherosclerotic disease (high-risk group), 2 7.8% of patients had definite atherosclerotic disease or diabetes. In the entire population, only 44% of patients with total cholesterol and low-density lipoprotein cholesterol levels while achieving therapeutic goals. The compliance rate of patients in low-risk group and high-risk group was higher than that in atherosclerotic disease and diabetes group. The relationship between the four different lipid-lowering drugs and the compliance rate was also studied: the simvastatin group was 5 1.8%, the pravastatin group was 42.9%, the fluvastatin group was 31.6% and the other drugs group was 12 .5%. Conclusions More than half of patients undergoing lipid-lowering therapy have not achieved their target for total cholesterol and LDL cholesterol. The survey shows that there is still a gap between the “prevention and treatment of dyslipidemia” and clinical practice, suggesting that more active lipid-lowering treatment is needed.