我院心内科血脂异常患者调降脂治疗达标现状和随访

Effect of Treatment and Follow-up in Patients with Dyslipidemia

目的:了解高脂血症患者经过调脂治疗3个月及降血脂达标情况。方法:分析经治疗3个月后我院心内科288例患高脂血症患者达标率(按中国“血脂异常防治建议”),并随访一年再观察其达标,发生心脏事件情况和药物不良反应。结果:3个月达标水平总胆固醇56.3％,低密度脂蛋白胆固醇62.2％,甘油三酯59.7％。三项指标均全部达标者40.6％,其中冠心病患者三项指标均达标者44.4％,而用他汀类治疗者使低密度脂蛋白胆固醇达标者54.2％,显著优于多烯康,月见草油等非他汀类(后者达表率9.4％)(P<0.01)。而用辛伐他汀20mg/d达标率优于10mg/d(P<0.01),氟伐他汀40mg/d优于20mg/d(P<0.05)。一年随访显示3个月已三项达标者有15.4％又出现不达标,而原三项未达标又有28.7％达标;发生急性冠脉事件2.8％,心脏性死亡0.69％,药物不良反应轻微。结论:我院调降脂治疗达标率较国内明显提高,可能是对血脂治疗重要性提高,药物品种及剂量选择恰当,加上开展生命网工程,对患者健康教育有关,但需清楚认识要使调降脂治疗长期达标任务艰巨。

Objective: To investigate the ratio up to par (RUTP) in patients with dyslipidemia and the situation after one - year' 8 follow - up. Methods: The ratio was got by analyzing the information of 288 patients with dyslipidemia once admitted in the internal medicine Dept. heart center of our hospital according to 'Recommendation on the Therapy of dyslipidemia' . One - year's follow - up was performed to observe the change of RUTP, cardiovascular events and side effect of therapy. Results: RUTP of T - chol, LDL -C, TG and all - three (including T - chol, LDL-C and TG) were respectively 56.3% , 62.2%, 59.7% and 40.6%. There were 44.4% patients with CHD that had all - three up to par. RUTP of LDL - C of group with statins(54.2% ) was much more higher than group with non - statins (9.4% ) such as Duoxikang and Yuejiancaoyou (P < 0.01) , Effect of simvastatin 20mg/d was better than simvas-tatin 10mg/ d and effect of fluvastatin 40 mg/ d was better than 20 mg/ d. After one - year' s follow - up, it shown that there were 15.4% patients turned from up to par of all - three to non - up to par and 28.7% patients turned from non - up to par to up to par of all - three, the incidences of acute coronary syndrome and eardiogenic mortality were 2.8% and 0.69% respectively. Adverse effects were smile. Conclusion: RUTP of lipids lowering in our hospital was obviously belter than other domestic reports. The reason may include more concern on lipids lowering therapy, proper choose of medicines and dose and health education to patients by the health care net. But the long - term lipids lowering therapy is still a formidable target, which should be clearly recognized.