Nash Mark S, Mendez Armando J
Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Arch Phys Med Rehabil. 2007 Jun;88(6):751-7. doi: 10.1016/j.apmr.2007.02.031.
To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines.
Cross-sectional.
Academic medical center.
Forty-one subjects (mean age +/- standard deviation, 34+/-11 y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years.
Not applicable.
Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines.
A total of 34.1% of subjects qualified for intervention based on the ATP II Guidelines and 63.4% based on ATP III (chi1(2) test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40 mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1% satisfied criteria for diagnosis of the metabolic syndrome.
A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.
根据权威指南评估符合降脂治疗性生活方式干预（TLI）条件的慢性截瘫患者的比例。
横断面研究。
学术医学中心。
41名运动完全性截瘫（美国脊髓损伤协会分级为A或B级）且损伤平面在T6 - L1、病程超过2年的受试者（平均年龄±标准差，34±11岁）。
不适用。
独立评估符合TLI条件的受试者比例，然后使用美国国家胆固醇教育计划成人治疗小组（ATP）II（1994年）和ATP III（2002年）指南进行比较。
根据ATP II指南，共有34.1%的受试者符合干预条件；根据ATP III指南，这一比例为63.4%（卡方检验=4.53；双侧，P = 0.003）。76%（31/41）的研究参与者高密度脂蛋白胆固醇水平低于ATP III设定的40 mg/dL的高危标准。近三分之一的受试者患有高血压，34.1%的受试者符合代谢综合征的诊断标准。
很大比例的年轻、看似健康的慢性截瘫患者存在心血管疾病风险，符合降脂TLI的条件。ATP III的更新指南增加了早期风险评估和干预的紧迫性。
