CAJ | 학술논문

目的比较不同指南评价我国临床血脂异常达标率的差异,深入理解"中国成人血脂异常指南"(简称指南)与国内外相关指南的异同,促进指南更好地推广和应用.方法对"第二次中国临床血脂控制现状多中心协作研究"调查的2094例患者,分别依据2007年发布的指南与1997年的"血脂异常防治建议"(简称建议)、美国2004年更新的国家胆固醇教育计划成人治疗组第三次报告(简称ATPⅢ)计算LDL-C目标值的达标率.结果 (1)依据建议、ATPⅢ和指南,总达标率分别为62%、34%和50%.(2)以指南为参照,全部极高危和40%高危患者被建议低估;低、中和高危患者各有40%以上被ATPⅢ高估.(3)指南与建议达标率差异中,90%由危险分层不同所致;ATPⅢ与指南达标率差异中,约30%由危险分层不同所致,70%由治疗目标值不同所致.结论应用不同指南为依据,达标率差异明显.指南较建议危险分层更加积极,较ATPⅢ简单实用.指南更适合在我国人群使用,应大力推广.
목적 비교불동지남평개아국림상혈지이상체표솔적차이,심입리해"중국성인혈지이상지남"(간칭지남)여국내외상관지남적이동,촉진지남경호지추엄화응용.방법 대"제이차중국림상혈지공제현상다중심협작연구"조사적2094례환자,분별의거2007년발포적지남여1997년적"혈지이상방치건의"(간칭건의)、미국2004년경신적국가담고순교육계화성인치료조제삼차보고(간칭ATPⅢ)계산LDL-C목표치적체표솔.결과 (1)의거건의、ATPⅢ화지남,총체표솔분별위62%、34%화50%.(2)이지남위삼조,전부겁고위화40%고위환자피건의저고;저、중화고위환자각유40%이상피ATPⅢ고고.(3)지남여건의체표솔차이중,90%유위험분층불동소치;ATPⅢ여지남체표솔차이중,약30%유위험분층불동소치,70%유치료목표치불동소치.결론 응용불동지남위의거,체표솔차이명현.지남교건의위험분층경가적겁,교ATPⅢ간단실용.지남경괄합재아국인군사용,응대력추엄.
Objective To better understand the similarities and disparifies between the newly issued Chinese Guidelines on Prevention and Treatment of Oyslipidemia in Adults(CG)and exist relevant guidelines by comparing the actual effect on assessment of current clinical management of dyslipidemia in China,in order to promote the use of CG in clinical practice.Methotis Study participants included 2094 patients from the Second Multi-center Survey of Dyslipidemia Management in China.The goal attainment rate was defined as the proportion of participants who achieved their target low-density lipoprotein cholesterol (LDL-C)levels specified by CG,the Chinese Expert Recommendations on Prevention and Treatment of Dyslipidemia(CR),the upsated Adult Treatment Panel Ⅲ of the National Cholesterol Education Program (ATP Ⅲ),respectively.Results (1)The overall goal attainment rates were 62%,34%and 50% according to CR,ATPⅢand CG,respectively.(2)With reference to the CG risk stratifications,the risk of nearly 40%of high risk patients and all very high risk patients were underestimated by CR,whereas the risk of more than 40%of patients in any risk groups were overestimated by ATP Ⅲ.(3)The disparities in risk stratifications accounted for 90%of the difference in overall goal attainment rate(12%)between CR and CG,while the disparities in the risk stratifications and that in LDL-C target levels were responsible for 29% and 71%of the difference(16%),respectively,between ATP Ⅲ and CG.Conclusions There were significant differences in goal attainment rates assessed by different clinical practice guidelines.CG is more aggressive in risk stratification than CR but simpler and easier to use than ATP Ⅲ,and hence more appropriate to Chinese patients and should be widely promoted in China.