根据《中国成人血脂异常防治指南(2016年修订版)》再分析DYSIS-China横断面调查

Re-analysis of DYSIS-China cross-sectional survey according to"Chinese guidelines for the prevention and treatment of dyslipidemia in adults(2016 revision)"

目的探讨中国血脂异常患者降脂治疗后血脂状况和特征。方法应用《中国成人血脂异常防治指南(2016年修订版)》的标准对DYSIS-China数据库进行再分析。DYSIS-China数据库共纳入25317例接受至少1种降脂药物治疗至少3个月的中国血脂异常患者。对这些患者的低密度脂蛋白胆固醇(LDL-C)和非高密度脂蛋白胆固醇(非-HDL-C)达标率,以及血脂水平与目标值之间的差距等数据进行描述性统计。结果中国血脂异常患者中96.6%为高危和极高危,总体LDL-C达标率仅为37.3%。极高危、高危、中危和低危患者的LDL-C达标率分别为26.9%、44.1%、78.5%和99.7%。东北地区LDL-C达标率和非-HDL-C达标率低于其他地区。就诊三级医院和心血管内科的患者的LDL-C和非-HDL-C达标率高于其他级别的医院和科室。LDL-C水平距离目标值的平均差距在极高危和高危患者中分别是39.7 mg/dl和33.9 mg/dl。87.7%的患者使用他汀单药治疗,最常用辛伐他汀和阿托伐他汀,以中等强度的辛伐他汀20~40 mg/d或等价他汀为主。结论中国血脂异常患者经降脂治疗后LDL-C达标率仍然很低,尤其是高危和极高危患者的LDL-C与目标值之间仍然存在巨大差距。

Objective To investigate the status and characteristics of blood lipids in Chinese dyslipidemia patients treated with lipid-lowering therapy.Methods According to the criteria in the"Chinese guidelines for prevention and treatment of dyslipidemia in adults-2016 version",Dyslipidemia International Study-China(DYSIS-China)database was re-analyzed.DYSIS-China database included 25317 dyslipidemia out-patients who received at least one lipid-lowering drug for at least three months.Compliance rate of low density lipoprotein cholesterol(LDL-C)and non-HDL-C,and the gap between actual levels and target level of these patients were descriptively analyzed.Results The analysis of DYSIS-China database showed that 96.6%of out-patients with dyslipidemia were at high and very high risk,and the overall compliance rate of LDL-C was only 37.3%.The compliance rate for very high risk,high risk,moderate risk and low risk patients was 26.9%,41.1%,78.5%and 99.7%respectively.The compliance rate of LDL-C and non-HDL-C in Northeast China is obviously lower than that in other regions.The compliance rate for patients who visited to tertiary hospital and cardiology department was higher than non-tertiary hospital and other departments.The average difference between LDL-C actual level and target level was 39.7 mg/dl and 33.9 mg/dl in very high risk and high risk patients.87.7%of patients received statin monotherapy.Simvastatin and atorvastatin were most commonly used.Majority of patients received moderate-intensity of simvastatin,20-40 mg/d or equivalent statins.Conclusions The compliance rate of lipid lowering therapy in Chinese patients is still very low,especially for high risk and very high risk patients.There is a big gap between LDL-C actual level and target level.