Lloyd J K
Br Heart J. 1975 Feb;37(2):105-14. doi: 10.1136/hrt.37.2.105.
Hyperlipidaemia in children is most commonly expressed as hypercholesterolaemia. "Normal values" for serum cholesterol, if defined statistically, vary between communities, and levels of cholesterol in childhood above which an increased risk of coronary heart disease in adult life may be expected have not been firmly established. It is suggested that serum cholesterol concentration over 250 mg/dl (6.47 mmol/l) in a child over 1 year of age merits detailed investigation, including full lipoprotein analysis, and levels of serum cholesterol between230 and 250 mg/dl (5.95-6.47 mmol/l) should be repeated with further studies if indicated. Secondary hyperlipoproteinaemia rarely presents diagnostic problems but must always be excluded. The only primary hyperlipoproteinaemia likely to be encountered in childhood is familial hyperbetalipoproteinaemia in its common heterozygous form. The most effective means to date of lowering serum cholesterol in this condition is cholestyramine, but the long-term consequences of therapy are not known and treatment should at present be limited to children from high-risk families. Long-term follow-up is essential and until results of such studies are available population screening is unjustified.
儿童高脂血症最常见的表现为高胆固醇血症。血清胆固醇的“正常数值”，如果从统计学角度定义，在不同人群中有所差异，而且尚未明确确定儿童时期何种胆固醇水平会使成年后患冠心病的风险增加。建议1岁以上儿童血清胆固醇浓度超过250mg/dl（6.47mmol/l）时，应进行详细检查，包括全面的脂蛋白分析；如果有指征，血清胆固醇水平在230至250mg/dl（5.95 - 6.47mmol/l）之间的也应重复检查并进一步研究。继发性高脂蛋白血症很少带来诊断难题，但必须始终排除。儿童时期可能遇到的唯一原发性高脂蛋白血症是常见杂合形式的家族性高β脂蛋白血症。迄今为止，在这种情况下降低血清胆固醇最有效的方法是考来烯胺，但治疗的长期后果尚不清楚，目前治疗应仅限于高危家庭的儿童。长期随访至关重要，在获得此类研究结果之前，进行人群筛查是不合理的。
