Blair T P, Bryant F J, Bocuzzi S
Department of Internal Medicine, Naval Hospital, Bethesda, Md 20814.
Arch Intern Med. 1988 May;148(5):1046-8.
National trials have demonstrated that the incidence of myocardial infarction and coronary death can be decreased, and progression of atherosclerosis delayed or reversed, by administration of bile acid-binding resins. A cholesterol clinic was established to determine whether a simple protocol would be effective in a nonvolunteer population referred by practicing cardiologists. The clinic was operated by a nurse who followed a stepped-care protocol, similar in concept to that used for treatment of hypertension. In the treatment of 86 patients with type II hyperlipidemia (cholesterol level, greater than 6.85 mmol/L [greater than 265 mg/dL]; triglyceride levels, normal or mildly elevated), compliance with the protocol resulted in reductions in cholesterol level of 19% in patients treated with diet, 23% for those treated with diet plus a bile sequestrant (colestipol hydrochloride or cholestyramine resin), and 25% in those treated with diet plus other cholesterol-lowering drugs. This method of treatment was effective and may serve as a model for the management of large numbers of patients with this condition.
全国性试验表明，通过服用胆汁酸结合树脂，心肌梗死和冠状动脉死亡的发生率可降低，动脉粥样硬化的进展可延缓或逆转。设立了一个胆固醇诊所，以确定一个简单的方案对由执业心脏病专家转诊的非自愿人群是否有效。该诊所由一名护士运营，遵循逐步护理方案，其概念与用于治疗高血压的方案类似。在治疗86例II型高脂血症患者（胆固醇水平大于6.85 mmol/L[大于265 mg/dL]；甘油三酯水平正常或轻度升高）时，遵循该方案导致接受饮食治疗的患者胆固醇水平降低19%，接受饮食加胆汁螯合剂（盐酸考来替泊或消胆胺树脂）治疗的患者降低23%，接受饮食加其他降胆固醇药物治疗的患者降低25%。这种治疗方法有效，可作为管理大量此类患者的模式。
