内科住院病人血脂控制状况分析

A current status on the patients with hypercholesterolemia by lipid lowering treatment

目的 观察院内高胆固醇血症患者的药物治疗血脂达标率及他汀类药物治疗的安全性和对病人的个体差异。方法 对177例院内诊断为高脂血症的病人，随机给予药物调脂治疗〉2个月，于门诊复查血脂，根据1997年我国的《血脂异常防治建议》了解血脂达标情况，同时观察不同他汀类药物和同一药物不同剂量的降脂幅度，以及对达标率的影响。结果 总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）总达标率分别为25％和40％，他汀类药物LDL-C的达标率为51．4％．明显高于贝特类及烟酸制剂及海鱼油（15．9％）。辛伐他汀大剂量比低剂量，具有更高的LDL-C达标率和降低幅度且安全性好。结论 他汀类药物适合作冠心病预防的一线用药，大剂量他汀更适合高脂血症病人的早期使用。

Objective To study the success rate and related factors on lipid lowering treatment in the hypercholesterolemia patients. Methods One hundred seventy seven patients suffering from hypercholesterolemia were selected to receive the lipid lowering treatment for at least 2 months.Serum lipid level was determined for each patient again in outpatient department,and we observed the lipid changes and the success rate among different medications, according to the Chinese National Recommendations for Prevention and Treatment of Dislipidaemia. Results 1）The overall success of cholesterol and low-density lipoprotein cholesterol （LDI-C） were 25% and 40%.2） The success rate of LDL-C was 51.4%for pa- tients using statin,and it was significant when comparing with using fibrate, nicotinamide and fish oil. 3） Both the success rate and the LDL-C level decreasing by were higher when using 20 mg simvastatin compared with using 5 mg simvastatin, and it was rather safe. Conclusions Statin is fit for the preliminary prevention of CAD,and high dose would be more efficiency.