慈溪市医疗卫生人员对胆固醇知识认知水平的横断面调查

目的了解慈溪市医疗卫生人员对胆固醇相关知识的认知水平,为心血管病健康教育提供指导。方法对选取的三级医院、二级医院、乡镇中心卫生院及社区卫生服务站4个级别医院的医师采取自填封闭式问卷进行集中调查,并结合个案访问,共调查医疗卫生人员243人对胆固醇知识认知水平。结果被调查医师对血清总胆固醇(TC)升高、血清低密度脂蛋白胆固醇(LDL-C)升高、血清高密度脂蛋白胆固醇(HDL-C)降低可增加心血管病危险的认知率分别为97.6%、89.3%及71.6%,LDL-C作为对冠心病发生起最重要作用的血脂成分的认知只有49.0%。各级医生对正常成人血脂合适范围的准确回答率普遍偏低,对于冠心病患者TC、LDL-C开始治疗性生活方式改变(TLC)和药物治疗标准的正确回答率大都低于20.0%;对冠心病患者TC和LDL-C控制目标的正确回答率低于35.0%;对每天胆固醇摄入量的认知率最高为35.0%。被调查的医师中,知道自己血脂水平的为40.3%,控制自身胆固醇摄入的为60.5%,采用膳食治疗血脂异常的为64.6%,给所有心血管病患者测血脂的为86.8%,而对其他患者仅为13.6%,限制心血管疾病患者摄入饱和脂肪酸和胆固醇的高于70%,而对其他患者不足20%,对于单纯高胆固醇血症给予他汀类药物治疗的为68.3%。结论医疗卫生人员对胆固醇相关知识的认知还存在一定差距,心血管病健康教育应作为改善认知水平的主要手段。     

京沪穗三地医师血脂异常防治知识调查

目的:了解我国医疗卫生人员血脂异常防治观念和知识的认知水平,为开展中国胆固醇教育提供指导.方法:于2004年在北京、上海、广州三地对相关科室医务人员进行问卷调查,资料完整的998份.结果:只有86.5%医疗卫生人员的了解冠心病患者LDL-C的目标值.只有57.7%的医师较全面了解血脂筛查对象,有32.9%的医师不了解调脂治疗的首要目标,有25.8%的医师仅依据化验单诊断血脂异常,只有49.6%的医师会在调脂治疗后1月左右复查血脂,约19.1%的医师选择血脂达标后会减量或停药.上述情况随医院级别的降低而降低.结论:我国医疗卫生人员的血脂异常防治观念与治疗指南相比,尚有很大差距.胆固醇教育亟待加强.     

社区中老年血脂异常600例综合管理效果分析

心血管病已成为中国城市和乡村人群的第一位死亡原因,血脂异常是冠心病和缺血性脑卒中等致残、致死性动脉粥样硬化性疾病的独立危险因素之一。2002年浙江省居民营养与健康状况调查项目显示成年人血脂异常总患病率为46.48%。     

血脂检测及与临床协作的重要性

<正>为减少心血管事件的发生,维护人民群众的健康,中国胆固醇教育计划(CCEP)"冠心病血脂干预推广"项目已经出台。血脂分析对动脉粥样硬化(AS)、冠心病的防治具有重要意义[1,2]。血脂测定是否准确是血脂异常防治、降低冠心病和冠     

血脂异常患者健康知识与治疗依从性的调查分析

目的探讨血脂异常患者（以下简称＂患者＂）健康知识与治疗依从性的现状,为采取针对性的干预措施提供科学依据。方法采用一般资料调查表、血脂健康知识调查表、治疗依从性量表,对180例患者进行相关的问卷调查。结果患者的健康知识总体为高、中、低水平分别为22.2%、67.8%、10%;治疗依从性总体水平好、一般、差分别为21.1%、55.6%、23.3%。结论护士应对患者开展针对性、系统的血脂相关知识教育,提升健康知识水平,提高治疗依从性,从而减轻或治愈血脂异常,改善患者生活质量。     

沈阳市区中老年人群血脂水平调查分析

目的调查沈阳部分职业人群血脂现状及血脂异常流行分布.方法以沈阳市政府机关、科教卫生、企事业单位中老年人群3 919例为观察对象,测定血脂项目包括总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)及甘油三脂(TG).结果本组人群血脂水平随年龄增加而增高,TC和LDL-C 50岁以后,女性高于男性,TG 60岁以后女性高于男性;HDL-C各年龄组均高于男性;高TC血症多于高TG血症.血脂异常者中年男女为45.1%及41.0%,老年男女为50.7%及62.5%.结论沈阳中老年人群血脂异常者较为普遍,表明动脉粥样硬化性心血管病风险明显增高,防治血脂异常势在必行.     

《中国成人血脂异常防治指南》知晓情况的调查

目的了解基层医院医生对《中国成人血脂异常防治指南》的知晓和掌握情况。方法对参加《黄河口心血管病论坛》会议的山东省东营市的县区、乡镇、社区医院302名内科医师以不记名问卷方法进行调查。结果在被调查302份问卷中,80.2%的基层医师能正确回答血脂异常防治的最主要目的是防治冠心病。在此次培训前看过《中国成人血脂异常防治指南》的,占总调查人数的26.8%。19.6%的医师能正确回答血脂异常干预的首要目标是低密度脂蛋白胆固醇（LDL-C）。对血脂异常危险分层标准及相应危险分层的LDL-C目标值知晓率为18.1%;不稳定型心绞痛和急性心肌梗死的LDL-C目标值的掌握情况仅为16.4%。结论基层医师对《中国成人血脂异常防治指南》的知晓率较低,对血脂异常危险因素评估分层原则等知识的正确掌握率较低,建议加强培训基层临床医师血脂异常防治知识。     

浅析护理干预对血脂异常者的影响

目的探讨护理干预对血脂异常人群的作用与影响。方法将200例参加健康体检的符合血脂异常且无其他严重并存疾病的患者随机分为2组,对照组仅进行相关知识宣教;观察组进行护理干预,2组均未使用药物降脂,复查血脂,以检测血脂结果是否达到目标值并进行对比。结果干预后观察组总胆固醇、甘油三酯、低密度脂蛋白胆固醇均显著低于对照组（均P〈0.05）。结论护理干预可增强患者的保健意识和自我管理能力,从而有效控制血脂水平,同时对血脂异常人群具有明显的防治作用。     

血脂异常患者在社区健康教育干预下的效果评价

目的:探索社区健康教育与干预综合防治措施对血脂异常的有效性。方法:对214例血脂异常患者进行血脂异常危险因素的健康教育干预,观察干预前后患者对血脂异常知识、态度和行为(knowledge,attitude and behaviour,KAB)的变化和血脂控制情况。结果:经健康教育干预后,血脂异常患者对血脂异常的知识、态度和行为(KAB)有明显改变,对血脂异常的危害和防治等卫生知识的认识水平有了提高,限制高脂食物、进行适当的锻炼等饮食生活方式得到一定改善,血脂异常得到控制的人数明显上升(P<0.01)。结论:社区健康教育与干预对血脂异常患者的综合防治效果良好。     

中年心血管病患者脂代谢水平治疗前后对比分析

目的 分析对比中年人冠心病治疗前后的血脂水平,为心血管病治疗提供依据.方法 日常门诊患者80例,分为冠心病组,健康对照组,每组40例,用酶法测定总胆固醇(TC)、三酰甘油(TG)、用直接法测定高密度脂蛋白(HDL-C)、用免疫透射比浊法测定载脂蛋白ApoA1、ApoB,对两组人群治疗前后血脂水平对比,对两组人群治疗后血脂水平作自身前后对比.结果 冠心病组总胆固醇明显高于对照组(P<0.01),三酰甘油高于健康对照组(P<0.05)高密度脂蛋白低于健康对照组(P<0.05),载脂蛋白明显低于健康对照组(P<0.01).治疗后冠心病明显有所改善,自身前后对比.结论 中年心血管病血脂代谢水平以总胆固醇、三酰甘油增高,高低密度脂蛋白、载脂蛋白降低为主,因此,加强血脂异常的预防保健治疗,对降低心血管病的发病来说,保护人群健康具有重大意义.     

通心调脂胶囊对冠心病合并高脂血症患者血脂和血液流变学的影响

目的研究通心调脂胶囊对冠心病合并高脂血症患者血脂和血液流变学的影响。方法将80例冠心病合并高脂血症患者随机分为治疗组（40例）和对照组（40例）,对两组血脂和血液流变学指标进行比较。结果治疗组血脂总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）明显降低,高密度脂蛋白（HDL—C）明显升高;血液流变学全血黏度高切变率（ηbH）、全血黏度低切变率（ηbL）、血浆比黏度（ηp）、血细胞比容（HCT）、纤维蛋白原（Fib）明显降低。与对照组比较有显著性差异（P〈0．05或P〈0．01）。结论通心调脂胶囊可明显改善冠心病合并高脂血症患者血脂和血液流变学指标,是治疗冠心病合并高脂血症患者的有效药物。     

Apparent protective effect of high density lipoprotein against coronary heart disease in the elderly

Background This study was designed to evaluate the relationship between high-density lipoprotein cholesterol (HDL-C) level and acute myocardial infarction (AMI) and coronary heart disease (CHD) death and to explore the protective effect of HDL against CHD in the elderly Chinese.Methods Started from 1986, 1211 retirees (92% males) were enrolled consecutively and studied prospectively. The average starting age was 70±9 years, and that at the end of the study was 80±9 years. During the follow-up study, all the participants received yearly physical examination and blood chemistry survey from 1986-2000. The average duration of the follow up study was 11.2 years. The end point of this study was either attacks of AMI or death due to CHD and other causes. CHD risk factors were screened by logistic regression analysis. According to their HDL-C levels, cases were divided into low (&lt;1.03 mmol/L), medium (or normal, 1.03-1.56 mmol/L) and high (&gt;1.56 mmol/L) level groups, the differences in incidence of AMI and CHD death in each group were analyzed.Results The cumulative attacks of acute coronary syndrome (mostly AMI) were 214 cases, including 89 cases of coronary death and 308 death caused by other diseases during the follow up study. AMI occurrence and CHD death in normal HDL-C group were lower than those in the low HDL-C group by 40% and 53%; and those in the high HDL-C group were lower than in the normal group by 56% and 50%, respectively. Statistical analysis on normal lipid cases （411 cases, total cholesterol&lt;5.17mmol/L, triglyceride&lt;1.69 mmol/L） revealed that the cases at low HDL-C level had similar rates of AMI events and CHD mortality as those of the entire group (including hyperlipidemia); however, AMI attacks and CHD deaths decreased significantly at the normal and high HDL-C levels. The results demonstrated that the protective effect of HDL against coronary artery disease is more prominent in people with low lipid level.Conclusion Low HDL is an important independent risk factor for AMI attacks and CHD death in the elderly; high HDL has significant protective effect against coronary artery disease.     

Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki Heart Study

In the Helsinki Heart Study, a randomized five-year, double-blind trial, a 34% reduction in the incidence of coronary heart disease (CHD) was observed in dyslipidemic men treated with gemfibrozil. Averaged over the five years of the trial, gemfibrozil therapy produced, compared with placebo, mean decreases of 10% in serum total cholesterol level, 14% in non-high-density lipoprotein (HDL) cholesterol level, 11% in low-density lipoprotein (LDL) cholesterol level, 35% in triglyceride level, and a mean increase of 11% in HDL cholesterol level from baseline levels measured prior to treatment. While changes in HDL cholesterol level were similar in all Fredrickson types, the effect on concentrations of total cholesterol and LDL cholesterol was largest in type IIA and on LDL minimal in type IV. The reduction of CHD incidence over placebo was largest in type IIB and smallest in type IIA. The lipid changes were dependent on lipid levels prior to treatment and on compliance with the medication regimen. When risk factors for CHD, including age, blood pressure, smoking and drinking habits, baseline lipid levels, and exercise and relative weight, were controlled by applying the Cox proportional hazards model, the changes in serum HDL and LDL cholesterol levels were both statistically significantly associated with the decline in CHD incidence within the gemfibrozil-treated group. The large decrease in serum triglyceride levels had relatively small effect on CHD incidence. Thus, the results of this study, together with earlier observations, suggest that both elevating HDL and lowering LDL cholesterol levels are effective in the primary prevention of CHD.     

Lipids in women: screening and treatment

Hyperlipidemia is a risk factor for coronary heart disease (CHD) in both men and women, although the association between total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and CHD risk differs in men and women. Although several clinical trials of lipid lowering for both primary and secondary prevention of CHD have been conducted, women have not always been included, have been included in small numbers, or have not had their results analyzed separately. CHD risk assessment is an important component of decision making about screening and treatment of hyperlipidemia. This article presents guidelines for screening and treatment of hyperlipidemia in women with CHD, in healthy women, and in women at risk for CHD.     

“治未病”思想在防治高脂血症临床探讨

目的观察"治未病"思想防治高脂血症的临床疗效。方法将93例出现血脂升高的非高脂血症患者随机分为两组。给予防预组患者应用"治未病"思想进行综合干预,常规组患者则按照常规模式进行干预,对两组患者的总体治疗效果、高脂血症发生率以及治疗前后血脂水平改善情况进行对比分析。结果防预组患者的总体治疗效果显著优于常规组,且高脂血症发生率明显低于常规组(均P0.05),治疗后,两组血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平较治疗前均显著降低,高密度脂蛋白胆固醇(HDL-C)水平显著升高,防预组患者的血脂改善水平明显优于常规组(均P0.05)。结论 "治未病"思想在防治高脂血症中具有良好的运用效果,能有效降低患者的血脂水平,避免或减少高脂血症的发生。     

Hyperhomocysteinemia and hyperlipidemia in coronary heart disease

ＯｂｊｅｃｔｉｖｅＴｏｅｘａｍｉｎｅｔｈｅｒｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｃｏｒｏｎａｒｙｈｅａｒｔｄｉｓｅａｓｅ（ＣＨＤ）ａｎｄｓｅｒｕｍｌｉｐｉｄ,ｐｌａｓｍａｈｏｍｏｃｙｓｔｅｉｎｅ（ＨＣＹ）ａｓｗｅｌａｓｔｈｅｆａｃｔｏｒｓｒｅｌａｔｅ...     

冠心病和高血压病患者的血脂及载脂蛋白

冠心病(CHD)、高血压病(EH)是心血管疾病中严重危害人类健康的主要病种,故减少及预防CHD和EH的发生十分重要.在CHD的诸多危险因素中以高血脂症影响较大.本研究探讨了CHD及EH病人的血脂、脂蛋白及载脂蛋白的代谢及临床意义,并与正常人进行比较,结果表明,CHD及EH病人的脂质代谢异常,以载脂蛋白、脂蛋白最为明显.对CHD、EH病人及具有CHD危险人群,除进行血脂监测外,还应监测脂蛋白及载脂蛋白的变化,及时纠正异常的脂代谢,以降低CHD的发病率及死亡率.     

A long-term follow-up study of serum lipid levels and coronary heart disease in the elderly

Background It is still controversial whether or not the correlation between lipid abnormality and coronary heart disease (CHD) becomes weaker in the elderly, and whether patients above 80 years old still benefit from lipid management for the secondary prevention of CHD. The purpose of this study is to assess the correlation between hyperlipidemia and the risk of CHD events in the elderly, and to determine if it is appropriate to use lipid-lowering drugs in those aged above 80, as prescribed by the recommended guidelines for lipid management.Methods One thousand two hundred and eleven retirees, mainly males (92%), aged 70±9 years, were enrolled in this study. Lifestyle habits and medical history were recorded via questionnaires. During the period 1986 -2000, all subjects participated in an annual physical examination with a blood chemistry survey. The mean follow-up period was 11.2 years. Subjects with incidental illnesses, especially cardiovascular diseases, were diagnosed or treated promptly. Serum li     

天津市1359名离退休老年人血脂倾向分析

目的研究天津市离退休老年人高血脂的分布情况.方法以2002年天津市老年人健康查体人群为研究对象,选择60岁以上老年人1 359人进行血脂分析.用氧化酶法测定血清总胆固醇（TC）和三酰甘油（TG）,用聚乙二醇沉淀法测定高密度脂蛋白（HDL-C）.结果老年人高脂血症发病率及血脂水平随增龄而下降,高峰期在60～69岁,以高TG血症为主.结论血脂异常已经成为老年医学领域不可忽视的重要研究课题,为减少老年人冠心病、糖尿病、高血压、脑血管病的患病率和死亡率,预防高脂血症是至关重要的.天津市离退休老年人血脂控制情况较好,另外,应加强对高TG血症的监测,社区全科医生有必要加强对相关知识的宣教.