Råstam L, Luepker R V, Pirie P L
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis.
Am J Prev Med. 1988 Sep-Oct;4(5):244-8.
Public screening for elevated blood cholesterol has become a common practice, supported by national recommendations. However, little is known about the response to referral for medical follow-up of those found to have high cholesterol levels. During a one-year period, 424 adults from a population-based screening and education program were referred to medical care after twice having elevated blood cholesterol levels. When they were remeasured approximately six months later, they were contacted for a telephone interview and 98% agreed to participate. While 82% remembered the referral, only 57% had actually visited a physician. An additional 8% had had telephone contact with a physician. Of the 237 who visited a physician, 76% had a cholesterol determination done during the first visit and 76% were advised to alter their diet by changing their fat consumption or losing weight. Referral to a nutritionist was suggested for 16%. Of the 424 participants, 280 (66%) reported substantial dietary change, either self-initiated or as a result of seeing a physician. Nineteen subjects (5%) were on lipid-lowering medication at the time of the interview. These observations suggest that a substantial portion of those screened will obtain follow-up care after two elevated blood cholesterol measurements in a screening setting. However, many never receive attention for this condition. Continued public and physician education is necessary to treat hypercholesterolemic individuals appropriately.
在国家建议的支持下，针对高胆固醇血症的公众筛查已成为一种常见做法。然而，对于那些被发现胆固醇水平高的人被转介接受医学随访后的反应，我们了解甚少。在一年时间里，424名来自基于人群的筛查和教育项目的成年人在两次出现血胆固醇水平升高后被转介接受医疗护理。当大约六个月后对他们进行重新测量时，我们通过电话采访联系了他们，98%的人同意参与。虽然82%的人记得被转介一事，但只有57%的人实际去看过医生。另外8%的人与医生进行过电话联系。在237名看过医生的人中，76%的人在首次就诊时进行了胆固醇测定，76%的人被建议通过改变脂肪摄入量或减肥来调整饮食。16%的人被建议转诊给营养师。在424名参与者中，280人（66%）报告称饮食有显著变化，要么是自行改变，要么是看医生后改变的。19名受试者（5%）在接受采访时正在服用降脂药物。这些观察结果表明，在筛查环境中，很大一部分接受筛查的人在两次血胆固醇测量升高后会获得后续护理。然而，许多人从未因这种情况得到关注。持续开展公众和医生教育对于恰当地治疗高胆固醇血症患者是必要的。
