血脂防治指南述评及对我国临床实践的解析

Blood cholesterol treatment guideline and infl uence on clinical practice in China

2013年ACC/AHA联合颁布了《降胆固醇治疗成人动脉粥样硬化性心血管疾病(ASCVD)风险指南》,2015年NLA发布了《以患者为中心的血脂异常管理建议》,引起了国内外广泛关注。与以往指南相比,新指南在降胆固醇治疗的思路上有较多更新,强调了他汀类药物在降低ASCVD风险方面的获益,不再设定降胆固醇治疗LDL-C的目标值,更新了一级预防风险评估模型等。如何对待这些新的指南,并结合我国国情开展血脂防治,是需要认真对待的问题。本文将简要介绍指南的要点,并对我国临床实践的影响进行剖析。

The American College of Cardiology and the American Heart Association released the 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults, and the National Lipid Association released national lipid association recommendations for patient-centered management of dyslipidemia： part 1-full report in 2015, which aroused wide attention at home and abroad. These new guidelines have many updates for the basic ideas and specific measures compared with the previous guidelines, including appropriate intensity of statin therapy, no longer achieving the intended target LDL-C levels, and the new pooled cohort equations to estimate 10-year ASCVD risk and so on. How to deal with these new guidelines, and to carry out the prevention and treatment of blood lipid combined with the Chinese national conditions, it＇s an issue that needs to be taken seriously. This paper will give a brief introduction to the main points of these guidelines, and analyze the influence on clinical practice of lipid control in China.