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目的了解北京市42家社区医院血脂相关辅助检查和调脂药物的配备情况以及社区医生血脂异常的诊治水平。方法于2003年7-10月采用面访和问卷调查的方法,访问北京市海淀区和朝阳区42家二级医院和一级医院主管业务的院长、检验科和药房负责人等,了解各医院血脂辅助检查的条件和药房调脂药物的配备情况,同时采用闭卷考试的方法对42家医院内科系统的632名医生进行了血脂异常临床有关知识及病例诊治水平的问卷调查。结果100％的社区医院可以检查血清总胆固醇和甘油三酯,87．5％和72．5％的医院有他汀类和贝特类调脂药物,100％的医院可以检测谷丙转氨酶和40．0％的医院可以检测血清肌酸激酶。社区医生正确回答血脂异常临床分型的比例为5．2％;为高胆固醇血症病例选择治疗方案的正确率为53．7％,制订降脂目标的正确率为17．6％。结论北京市社区医院的硬件条件基本上可以满足血脂异常防治的需求,要全面开展血脂异常的防治工作亟需提高社区医生的诊治能力。
Objective To understand the distribution of blood lipid-related laboratory tests, lipid-lowering drugs and the diagnosis and treatment of community-based dyslipidemia in 42 community hospitals in Beijing. Methods From July to October in 2003, interviewed and questionnaire surveyed the chiefs, laboratories and pharmacy supervisors of 42 second-class hospitals and first-class hospitals in Haidian District and Chaoyang District, The condition of assistant examination of blood lipids in hospital and the prescription of lipid-lowering drugs in pharmacy were studied. At the same time, a questionnaire survey was conducted on 632 doctors of 42 hospital internal medicine systems about the clinical knowledge of the dyslipidemia and the diagnosis and treatment of the disease. Results Serum total cholesterol and triglycerides were detected in 100% of community hospitals, statins and fibrate lipid-lowering medications in 87.5% and 72.5% of hospitals, and ALT and 40% in 100% of hospitals. 0% of hospitals can detect serum creatine kinase. The correct response rate of community doctors to the clinical classification of dyslipidemia was 5.2%. The correct rate of treatment options for patients with hypercholesterolemia was 53.7%, and the correct rate of lipid-lowering goals was 17.6%. Conclusion The hardware conditions of community hospitals in Beijing basically meet the needs of prevention and treatment of dyslipidemia. To prevent and cure dyslipidemia in an all-round way, it is urgent to improve the diagnosis and treatment ability of community doctors.