Dodson D J, Hooton T M, Buchwald D
University of Washington School of Medicine, Seattle, USA.
J Clin Pharm Ther. 1995 Apr;20(2):83-9. doi: 10.1111/j.1365-2710.1995.tb00633.x.
The National Cholesterol Education Program's guidelines for the detection, evaluation, and treatment of high serum cholesterol in adults were employed in screening 155 Southeast Asian refugees in a primary care clinic in Seattle, Washington. In order to determine the need for a therapeutic intervention, information also was collected on the presence of other coronary heart disease (CHD) risk factors. Male gender (39%), cigarette smoking (27%) and hypertension (26%) were the most common CHD risk factors; diabetes mellitus, obesity, a family or prior history of CHD or cerebral/peripheral vascular disease were each noted in less than 10%. The mean serum total cholesterol was 194 mg/dl. Thirty-seven (24%) patients required further lipoprotein analysis based on cholesterol level, history of CHD and risk factors for CHD. Twenty-one (66%) of 32 patients who underwent lipoprotein analysis (14% of all patients) were candidates for a therapeutic intervention for hypercholesterolaemia. Additionally, 14 (44%) patients undergoing lipoprotein analysis had depressed high-density lipoprotein levels (< 35 mg/dl). We conclude that CHD risk factors including hypercholesterolaemia are common in Southeast Asian refugee clinic patients and that in many, a therapeutic intervention may well be justified. Southeast Asian refugees should be routinely screened for hypercholesterolaemia and other CHD risk factors in accordance with the National Cholesterol Education Program's guidelines.
美国国家胆固醇教育计划(National Cholesterol Education Program)关于成人高血清胆固醇检测、评估及治疗的指南,被用于在华盛顿州西雅图市一家初级保健诊所对155名东南亚难民进行筛查。为了确定是否需要进行治疗干预,还收集了有关其他冠心病(CHD)危险因素存在情况的信息。男性(39%)、吸烟(27%)和高血压(26%)是最常见的冠心病危险因素;糖尿病、肥胖、冠心病或脑/外周血管疾病的家族史或既往史,每种情况的比例均不到10%。血清总胆固醇均值为194mg/dl。37名(24%)患者基于胆固醇水平、冠心病病史和冠心病危险因素需要进一步进行脂蛋白分析。在接受脂蛋白分析的32名患者中(占所有患者的14%),有21名(66%)是高胆固醇血症治疗干预的候选对象。此外,接受脂蛋白分析的14名(44%)患者高密度脂蛋白水平降低(<35mg/dl)。我们得出结论,包括高胆固醇血症在内的冠心病危险因素在东南亚难民诊所患者中很常见,而且对许多患者而言,进行治疗干预很可能是合理的。应按照美国国家胆固醇教育计划的指南,对东南亚难民常规筛查高胆固醇血症和其他冠心病危险因素。