Drexel H
Landeskrankenhaus Feldkirch.
Ther Umsch. 1995 May;52(5):340-2.
Lipid analysis should be tailored to the likelihood of hyperlipidemia and atherosclerosis. In healthy individuals without a family history of hyperlipidemia, it is sufficient to obtain readings of total cholesterol and high-density lipoprotein (HDL) cholesterol. In patients with a family history of hyperlipidemia, in addition, triglycerides should be measured. In patients with manifest atherosclerotic disease, the lipid profile should always include plasma cholesterol and triglycerides as well as HDL cholesterol; if these do not explain presence or extent of atherosclerosis, apolipoprotein (a) should be measured. Patients with diabetes mellitus should undergo the same diagnostic work-up as those with atherosclerotic disease. An apolipoprotein B reading (together with triglyceride levels) is sometimes helpful in patients with diabetes mellitus, allowing to estimate the size of triglyceride-rich lipoproteins. In patients with pancreatitis, longitudinal assessment of plasma triglycerides and, if available, measurement of HDL triglyceride are useful to unmask underlying hyperlipidemia.
血脂分析应根据高脂血症和动脉粥样硬化的可能性进行调整。对于没有高脂血症家族史的健康个体，获取总胆固醇和高密度脂蛋白（HDL）胆固醇读数就足够了。此外，对于有高脂血症家族史的患者，应测量甘油三酯。对于患有明显动脉粥样硬化疾病的患者，血脂谱应始终包括血浆胆固醇、甘油三酯以及HDL胆固醇；如果这些不能解释动脉粥样硬化的存在或程度，则应测量载脂蛋白（a）。糖尿病患者应接受与动脉粥样硬化疾病患者相同的诊断检查。载脂蛋白B读数（连同甘油三酯水平）有时对糖尿病患者有帮助，有助于估计富含甘油三酯的脂蛋白的大小。对于胰腺炎患者，纵向评估血浆甘油三酯，如有可能，测量HDL甘油三酯，有助于发现潜在的高脂血症。
