冠心病患者血脂治疗间隙的调查研究

目的　通过冠心病 (CHD)患者血脂治疗间隙的调查研究 ,了解住院CHD患者血脂异常的治疗现状。方法　在全国 6个城市 2 2家三级甲等医院回顾性调查住院的CHD患者病历 2 2 0 0份 ,记录患者入院 48h内的血清总胆固醇(TC)和低密度脂蛋白胆固醇 (LDL C)检查结果 ,以及住院期间血脂异常的治疗情况。结果　依照中国《血脂异常防治建议》和美国国家胆固醇教育计划 (第二次成人治疗方案 ) ,按CHD患者应开始药物治疗标准 ,即TC≥ 5 .2 0mmol L和 (或 )LDL C≥ 3.12mmol L ,有 35 .9%的患者未接受降血脂药物治疗 ;按治疗目标标准 (TC <4.6 8mmol L ,LDL C <2 .6 0mmol L) ,有 43.1%的患者未接受降血脂药物治疗。结论　住院CHD患者的血脂异常治疗存在较大的治疗间隙 ,其造成原因是多方面的。应强化降血脂治疗意识 ,采取各种积极手段 ,使CHD患者得到充分、合理的降血脂治疗 ,减少冠状动脉疾病的复发 ,提高CHD的二级预防水平。

Research on gap in treatment of abnormal plasma lipid in patients with coronary artery disease

Objective Several large international clinical trials have demonstrated that an active lipid lowering therapy will bring significant benefit to the patients with coronary heart disease (CHD) who have high blood cholesterol levels.The objective of the present study was to learn more about the result of treatment of in patients with CHD accompanied by hypercholesterolemia.Methods 2?200 in patients with CHD in 22 Class 3,Grade A hospitals in 6 cities of China were investigated retrospectively.The results of examination of serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL C) of the patients in 48 hours after admission and the results of the cholesterol lowering treatment they received in hospital were recorded.Results According to “Prevention and Treatment Recommendation for Abnormal Lipids” drawn up in China and the National Cholesterol Education Program of the United States (Adult Treatment Panel Ⅱ),36% of the patients with CHD who should be treated according to the standard for starting medicinal therapy (TC≥5.20 mmol/L and/or LDL C≥3.12 mmol/L) were not treated with medicines for lowering cholesterol,and 43% of the patients with CHD who should be treated according to the standard of therapeutic objective (TC<4.68 mmol/L,LDL C<2.60 mmol/L) were not treated with medicines for lowering cholesterol.Conclusions There is a big gap in the field of treatment for abnormal plasma lipid in the in patients with CHD due to many reasons.It is,therefore,necessary to intensify the consciousness of cholesterol lowering therapy and to take various active measures to let patients with CHD receive sufficient and reasonable cholesterol lowering therapy so as to reduce recurrent coronary events and to enhance the secondary prevention level in patients with CHD.