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目的了解冠心病患者血脂水平,分析其降脂治疗和达标的情况以及可能影响治疗达标的因素。方法对中南大学湘雅二医院2003年5月至2005年12月已确诊的冠心病患者101例,获取初始血脂水平以及在院期间接受降脂治疗的情况,通过电话、信函结合门诊复查形式进行随访,填答冠心病治疗调查问卷,记录结果并进行分析总结。结果(1)冠心病患者初始血脂异常率为60.6%,住院期间降脂治疗率为80.7%。(2)随访期间降脂治疗率为68.3%,低密度脂蛋白胆固醇(LDL-C)<2.59mmol/L者占65.3%。(3)达标与否和性别、年龄、学历、社会地位无关(P>0.05),但与经济收入、吸烟有关(P<0.05),并受到医疗质量、患者依从性、药效等影响。(4)所有接受降脂治疗的冠心病患者,丙氨酸转氨酶(ALT)与肌酸激酶(CK)值无显著升高,且与初始值比较差异无统计学意义(P>0.05)。结论冠心病降脂治疗仍存在很大治疗间隙和不少认识误区;达标与否和患者经济水平、生活方式(吸烟等)有关,并受到医疗质量、患者依从性、药效、社会等因素的影响;降脂药物的选择和剂量恰当时,长期治疗是安全的。
Objective To understand the level of blood lipid in patients with coronary heart disease and to analyze its lipid-lowering treatment and compliance, as well as the factors that may affect the treatment compliance. Methods 101 cases of CHD patients diagnosed in Xiangya Second Hospital of Central South University from May 2003 to December 2005 were enrolled in this study. Initial blood lipid levels and lipid-lowering treatment during hospitalization were obtained. Follow-up, fill in the questionnaire of coronary heart disease treatment, record the results and analysis summary. Results (1) The initial dyslipidemia rate was 60.6% in coronary heart disease patients and 80.7% in hospitalized patients. (2) The rate of lipid-lowering treatment during follow-up was 68.3%, and LDL-C <2.59mmol / L accounted for 65.3%. (3) There was no correlation between attainment and sex, age, educational level and social status (P> 0.05), but related to economic income and smoking (P <0.05), and was affected by medical quality, patient compliance and efficacy. (4) There was no significant difference in ALT and CK between all patients with coronary heart disease undergoing lipid-lowering therapy. There was no significant difference between the two groups (P> 0.05). Conclusion There are still many gaps and some misunderstandings in lipid-lowering treatment of coronary heart disease. The compliance or not is related to the patient’s economic level, lifestyle (smoking, etc.) and is influenced by the quality of care, patient compliance, efficacy and social factors Effect; long-term treatment is safe when lipid-lowering drugs are chosen and dosages are appropriate.