颈动脉内膜切除术患者高胆固醇血症的管理及其与颈动脉斑块形态的相关性
Managing hypercholesterolemia and its correlation with carotid plaque morphology in patients undergoing carotid endarterectomy.
作者信息
Rerkasem Kittipan, Gallagher Patrick J, Grimble Robert F, Calder Philip C, Shearman Clifford P
机构信息
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
出版信息
Vasc Health Risk Manag. 2008;4(6):1259-64. doi: 10.2147/vhrm.s3729.
PURPOSE
Hypercholesterolemia is a critical problem in patients with carotid atherosclerosis. The adequacy of attention to lipid risk factors in patients with carotid stenosis awaiting carotid endarterectomy (CEA) has rarely been studied. We also assessed patient awareness of hypercholesterolemia and carotid plaque morphology.
METHODS
A prospective study was conducted of 141 consecutive patients admitted electively for CEA. Each patient's medical history was taken. Plasma cholesterol concentrations were determined. Plaque histology was scored according to American Heart Association criteria and their modification.
RESULTS
Of patients who were aware of their hypercholesterolemia and who were receiving treatment, 28.6% had total cholesterol levels > or =5 mmol/L. Among those patients who had been told that they had no problem with hypercholesterolemia, 32.5% had plasma cholesterol concentrations > or =5 mmol/L. Among those patients who had never had their plasma cholesterol measured, 48.4% had total cholesterol levels > or =5 mmol/L. Patients in this last group tended to have more severe types of plaque pathology than those in other groups (12.9% plaque rupture).
CONCLUSIONS
Hypercholesterolemia does not seem to be well managed in patients awaiting CEA.
目的
高胆固醇血症是颈动脉粥样硬化患者的一个关键问题。对于等待颈动脉内膜切除术（CEA）的颈动脉狭窄患者，对脂质危险因素的关注是否充分鲜有研究。我们还评估了患者对高胆固醇血症的认知以及颈动脉斑块形态。
方法
对141例择期接受CEA的连续患者进行了一项前瞻性研究。记录每位患者的病史。测定血浆胆固醇浓度。根据美国心脏协会标准及其修订版对斑块组织学进行评分。
结果
在知晓自己患有高胆固醇血症且正在接受治疗的患者中，28.6%的患者总胆固醇水平≥5 mmol/L。在那些被告知自己没有高胆固醇血症问题的患者中，32.5%的患者血浆胆固醇浓度≥5 mmol/L。在那些从未检测过血浆胆固醇的患者中，48.4%的患者总胆固醇水平≥5 mmol/L。最后一组患者的斑块病理类型往往比其他组更严重（12.9%的斑块破裂）。
结论
等待CEA的患者中，高胆固醇血症似乎未得到有效控制。
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