基层血脂管理适宜技术中国专家建议(2022版)

Chinese Expert Recommendations on Lipid Management Options for Community Hospitals(2022 Edition)

血脂管理对于降低动脉粥样硬化性心血管疾病(ASCVD)风险至关重要。本适宜技术中国专家建议参考国内外最新指南,建立了适宜基层的血脂管理方法,要点如下:(1)低密度脂蛋白胆固醇(LDL-C)是ASCVD的关键致病因素,也是首要降脂干预靶点;(2)制定降脂方案应首先根据ASCVD风险确定LDL-C目标值;(3)中等强度他汀类药物治疗应作为降低LDL-C药物治疗的初始方案;(4)降脂治疗需长期维持LDL-C达标,同时应监测降脂药物安全性;(5)甘油三酯(TG)轻中度升高主要与ASCVD风险增加有关,仍以LDL-C为首要干预靶点;TG重度升高(≥5.6 mmol/L)者可首选贝特类药物,以降低急性胰腺炎风险。

Lipid management is essential to reducing risk of atherosclerotic cardiovascular disease(ASCVD).According to the newest guidelines,this document establishes lipid management options suitable for community doctors,and the key points are as follows:(1)Low-density lipoprotein cholesterol(LDL-C)is the key pathogenic factor of ASCVD and the primary intervention target;(2)Determining LDL-C goal level according to ASCVD risk is the first step;(3)Moderate intensity statins should be used as the initial medicine to reduce LDL-C;(4)Maintaining LDL-C under the goal level and monitoring safety related to lipid lowing treatment are important;(5)Mild and moderate hypertriglyceridemia is mainly related to ASCVD risk,LDL-C is still the primary intervention target.For patients with severe hypertriglyceridemia(≥5.6 mmol/L),fibrates are the first choice to reduce the risk of acute pancreatitis.