我国高胆固醇血症患者临床控制状况变化趋势2000年与2004-2006年达标率比较

目的了解近年来我国高胆固醇血症患者临床控制达标率的变化趋势。方法于2000年和2006年进行两次全国临床血脂控制状况调查,分别调查2136例和539例接受调脂治疗的高胆固醇患者。患者均来自我国大城市的三级甲等医院,接受调脂治疗≥2个月（同一药物同一剂量）。依据我国《血脂异常防治建议》评价患者调脂治疗的达标情况。结果第1次和第2次所调查的患者基本特征相似,平均年龄分别为60．9岁和60．0岁,男性分别占47．2％和49．3％,两次调查患者均以混合型高胆固醇血症为主（62．5％对66．8％）,调脂治疗以使用他汀类药物为主。第2次调查达标率明显高于第1次,总达标率分别为39．9％和26．5％（P〈0．01）。其中,单纯型高胆固醇血症患者的达标率分别为40．2％和28．8％,混合型高胆固醇血症患者分别为39．7％和25．0％,有冠心病危险因素但无动脉硬化疾病患者分别为45．9％和31．7％,动脉硬化疾病患者分别为26．7％和16．6％,使用他汀类药物患者分别为42．2％和30．1％,控制饮食者分别为38．5％和28．3％。结论近5年来高胆固醇血症患者治疗的达标率显著提高,但仍不理想。进一步提高达标率尚需多方努力。

The trends in clinical management of hyperlipidemia and goal attainment rate from 2000 to 2004 - 2006 in China

OBJECTIVE: To compare the clinical management of hyperlipidemia and goal attainment rate in year 2000 to year 2004 - 2006 in China. METHOD: Data from 2 retrospective surveys (2000 and 2004 - 2006) on clinical management of hyperlipidemia and goal attainment rate were analyzed. A total of 2136 patients were recruited in the 1st survey in year 2000 and 539 patients in the 2nd survey in year 2004 - 2006 from 25 and 21 tertiary hospitals of 12 metropolitan cities. Eligible patients had hyperlipidemia and received lipid-lowering therapy for more than 2 months at the time of survey. Serum lipid levels before and after treatment were analyzed and the goal attainment rate post therapy, defined according to the Chinese National Recommendations for Prevention and Treatment of Dislipidaemia published in 1997, was calculated. RESULTS: Clinical characteristics were comparable in patients from the 1st and 2nd survey: age (60.9 and 60.0 years), males (47.2% and 49.3%), type of lipid disorder (mixed hyperlipidemia 62.5% and 66.8%), and patients without coronary artery disease (CAD 61.2% and 68.6%). The percent of statins use was significantly higher in the 2nd survey than in the 1st survey (79.2% vs. 70.3%, P < 0.01). The goal attainment rate was significantly higher in the 2nd survey than in the 1st survey (39.9% vs. 26.6% for all patients, 40.2% vs. 28.8% for hypercholesterolaemia, 39.7% vs. 25.0% for mixed hyperlipidemia, 45.9% vs. 31.7 for patients without CAD, 26.7% vs. 16.6% for patients with CAD, 42.2% vs. 30.1% for patients using statins, and 38.5% vs. 28.3% for patients with diet control, all P value < 0.01). CONCLUSIONS: Although the goal attainment rate has been significantly increased in treated hyperlipidemia patients over recent 5 years in China, it is still far from optimal as suggested by the recommendations. Further efforts should be made to increase the goal attainment rate in patients receiving lipid-lowering therapy.