Tan Teng-Yeow, Chang Ku-Chou, Schminke Ulf, Lin Tsung-Kung, Huang Yu-Ching, Hung Jen-Wen, Chen Ting-Yao
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Clin Neurol Neurosurg. 2007 Nov;109(9):758-62. doi: 10.1016/j.clineuro.2007.06.008. Epub 2007 Aug 10.
In-hospital initiation and maintaining of lipid-lowering therapy (LLT) after discharge is recommended for dyslipidemic stroke patients. However, little is known about actual adherence to treatment in Taiwan. This study aims to describe the current practice of lipid testing and LLT and to identify predictors for patient to receive LLT.
Between February 2001 and December 2002, a total of 1105 consecutive ischemic stroke patients were prospectively registered. Dyslipidemic ischemic stroke patients were recruited and followed over a 6 months period.
In-hospital lipid testing was performed in 91% of all patients and LLT was initiated in 74% (350/476) of dyslipidemic patients. During the 6 months follow-up period, lipid testing was performed in 77% (266/345) and LLT was maintained in 45% (154/345) of patients. However, the target LDL cholesterol level (<100mg/dL) was achieved in only 30% (78/255) of patients. Older patients had a lower chance to receive LLT.
The in-hospital initiation of LLT and lipid testing was considered adequate as compared to other studies. However, after discharge from the hospital, many patients, especially older patients remained untreated. Efforts to close treatment gaps in lipid management require sustained quality improvement efforts. More awareness in this area is needed.
对于血脂异常的卒中患者,建议在住院期间启动并在出院后维持降脂治疗(LLT)。然而,台湾地区患者实际的治疗依从性情况鲜为人知。本研究旨在描述当前血脂检测和LLT的实施情况,并确定患者接受LLT的预测因素。
2001年2月至2002年12月期间,前瞻性登记了总共1105例连续的缺血性卒中患者。招募血脂异常的缺血性卒中患者,并进行为期6个月的随访。
所有患者中有91%在住院期间进行了血脂检测,血脂异常患者中有74%(350/476)启动了LLT。在6个月的随访期内,77%(266/345)的患者进行了血脂检测,45%(154/345)的患者维持了LLT。然而,只有30%(78/255)的患者达到了目标低密度脂蛋白胆固醇水平(<100mg/dL)。老年患者接受LLT的机会较低。
与其他研究相比,LLT和血脂检测的住院启动情况被认为是充足的。然而,出院后,许多患者,尤其是老年患者仍未接受治疗。缩小血脂管理中的治疗差距需要持续的质量改进努力。在这一领域需要提高更多认识。