Jancsó Zoltán, Varga Zsuzsa, Simay Attila, Ilyés István
Debreceni Egyetem, Orvos- es Egészségtudományi Centrum, Altalános Orvostudományi Kar, Családorvosi Tanszék.
Orv Hetil. 2005 Dec 25;146(52):2629-33.
The role of dyslipidemia is essential in the development of atherosclerosis, therefore continuing care of dyslipidemic patients is an extremely important task in cardiovascular prevention.
This study was aimed to investigate continuing care of dyslipidemic patients in general practices. Method of the study was a questionnaire survey, 397 patients of 39 general practices were involved into the study.
The cause of their continuing care was hypercholesterolemia in 91.7%, hypertriglyceridemia in 69%, decreased HDL-C in 18.4%, and these alterations frequently occurred together. Hypertension in 77%, disturbances of carbohydrate metabolism in 41.7%, increased BMI in 43.2% were found. Patients were smokers in 26.5%, given up smoking in 13.2%. They had cardiovascular problems in 56.5%, cerebrovascular problems in 18.6% and peripheral vascular ones in 20.3%. Patients were treated with lipid lowering drugs in 87.7%, statins were used in 81.7%, fibrates in 29.6% and both of them in 11.5%. The main results of continuing care were: in the whole group frequency of cholesterol level > 5.2 mmol/l decreased by 13%, frequency of triglyceride level >1.7 mmol/l decreased by 4%; cholesterol target values were reached in 3% of patients with high cardiovascular risk, in 22.2% of patients with medium risk, and in 66.7% of patients with mild risk.
These results suggest that there is a need for more intensive drug treatment of dyslipidemic patients to reach the target lipid levels, and for regular assessment of continuing care of these patients.
血脂异常在动脉粥样硬化的发展过程中起着至关重要的作用，因此持续关注血脂异常患者是心血管疾病预防中一项极其重要的任务。
本研究旨在调查全科医疗中血脂异常患者的持续护理情况。研究方法为问卷调查，涉及39家全科诊所的397名患者。
他们接受持续护理的原因中，高胆固醇血症占91.7%，高甘油三酯血症占69%，高密度脂蛋白胆固醇降低占18.4%，且这些异常情况经常同时出现。发现高血压患者占77%，糖代谢紊乱患者占41.7%，体重指数升高患者占43.2%。患者中吸烟者占26.5%，已戒烟者占13.2%。他们患有心血管疾病的占56.5%，脑血管疾病的占18.6%，外周血管疾病的占20.3%。87.7%的患者接受了降脂药物治疗，其中使用他汀类药物的占81.7%，贝特类药物的占29.6%，两者都使用的占11.5%。持续护理的主要结果是：在整个组中，胆固醇水平>5.2 mmol/l的频率下降了13%，甘油三酯水平>1.7 mmol/l的频率下降了4%；心血管高风险患者中有3%达到了胆固醇目标值，中风险患者中有22.2%达到了目标值，低风险患者中有66.7%达到了目标值。
这些结果表明，需要对血脂异常患者进行更强化的药物治疗以达到血脂目标水平，并对这些患者的持续护理进行定期评估。
