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儿童血脂异常指南。

Pediatric guidelines for dyslipidemia.

作者信息

Daniels Stephen R

机构信息

Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA.

出版信息

J Clin Lipidol. 2015 Sep-Oct;9(5 Suppl):S5-S10. doi: 10.1016/j.jacl.2015.03.105. Epub 2015 Apr 22.

Abstract

Clinical guidelines are developed to assist clinicians in complex clinical decision making. Modern guideline development includes a systematic review and grading of relevant literature and then using the evidence review to construct recommendations for clinical care which are also graded regarding the level of evidence supporting them. Pediatric guidelines for dyslipidemia were first published in 1992. There was then a gap during which no formal guidelines were developed. In 2011, the National Heart, Lung, and Blood Institute Integrated Guidelines for Cardiovascular Disease Risk Reduction in Children were published. This included an evidence review and clinical recommendations regarding dyslipidemia. This review process began in 2006. The evidence review ended in 2008, and they were published in 2011 because of an extensive and prolonged review process. These guidelines recommend universal screening for dyslipidemia at age 9 to 11 y with a focus on identifying young individuals with genetic dyslipidemia such as familial hypercholesterolemia. The guidelines also include lifestyle recommendations and recommendations for pharmacologic treatment for children with markedly elevated low-density lipoprotein cholesterol. The guideline process should include review of the implementation of guidelines in practice and should also include ongoing review of the guidelines with respect to a growing evidence base with new research findings.

摘要

临床指南旨在协助临床医生进行复杂的临床决策。现代指南的制定包括对相关文献进行系统回顾和分级,然后利用证据回顾构建临床护理建议,这些建议也会根据支持它们的证据水平进行分级。儿童血脂异常指南于1992年首次发布。此后有一段时期没有制定正式的指南。2011年,美国国立心肺血液研究所发布了《儿童心血管疾病风险降低综合指南》。其中包括关于血脂异常的证据回顾和临床建议。这一回顾过程始于2006年。证据回顾于2008年结束,由于审查过程广泛且耗时,这些指南于2011年发布。这些指南建议在9至11岁时对血脂异常进行普遍筛查,重点是识别患有遗传性血脂异常的年轻人,如家族性高胆固醇血症。该指南还包括生活方式建议以及针对低密度脂蛋白胆固醇显著升高的儿童的药物治疗建议。指南制定过程应包括对指南在实践中的实施情况进行审查,还应包括根据新的研究发现不断增加的证据基础对指南进行持续审查。

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