Wijesinghe L D, Gamage L, Berridge D C, Scott D J
Department of Vascular and Endovascular Surgery, St James's University Hospital, Leeds.
Ann R Coll Surg Engl. 1999 Jan;81(1):32-6.
Raised serum total cholesterol (TC) is an accepted risk factor for both coronary and peripheral vascular disease and three landmark trials have shown the benefit of lowering TC using statins. Vascular surgeons tend to measure TC, but little is known about how they manage hypercholesterolaemia or whether they believe treatment will be of benefit. A questionnaire was sent to listed members of the Vascular Surgical Society of Great Britain and Ireland seeking responses to a range of questions on the measurement and management of raised TC. In all, 374 questionnaires were sent out. The response rate was 67%. Over 90% of respondents said they measured TC and considered a level below 5.5 mmol/l as normal. The cut-off for initiating drug therapy, referral to a dietician or to a lipid specialist varied from 5.5 to 7.5 mmol/l. Most (62%) believed that lowering TC improved coronary mortality, but fewer (26%) that it prevented worsening of claudication. Although most vascular surgeons check for raised TC, the level at which treatment begins and the form it takes varies; in many cases being at odds with recommendations. Few surgeons are convinced of the benefits of lowering TC for claudication and nearly one-fifth do not believe it improves coronary mortality.
血清总胆固醇（TC）升高是公认的冠状动脉疾病和外周血管疾病的危险因素，三项具有里程碑意义的试验表明使用他汀类药物降低TC有益。血管外科医生倾向于测量TC，但对于他们如何处理高胆固醇血症，或者他们是否认为治疗会有益处，了解甚少。向英国和爱尔兰血管外科学会的在册会员发送了一份调查问卷，以寻求他们对一系列有关升高的TC的测量和管理问题的答复。总共发出了374份调查问卷。回复率为67%。超过90%的受访者表示他们测量TC，并将低于5.5 mmol/l的水平视为正常。开始药物治疗、转诊给营养师或脂质专家的临界值在5.5至7.5 mmol/l之间。大多数人（62%）认为降低TC可改善冠状动脉死亡率，但较少人（26%）认为它可预防间歇性跛行恶化。尽管大多数血管外科医生会检查是否存在升高的TC，但开始治疗的水平及其形式各不相同；在许多情况下与建议不一致。很少有外科医生确信降低TC对间歇性跛行有益，近五分之一的人不相信它能改善冠状动脉死亡率。
