Primrose E D, Savage J M, Boreham C A, Cran G W, Strain J J
Department of Child Health, Institute of Clinical Science, Royal Victoria Hospital, Belfast.
Arch Dis Child. 1994 Sep;71(3):239-42. doi: 10.1136/adc.71.3.239.
Hypercholesterolaemia is a major risk factor for the development of coronary heart disease (CHD). Early detection and management of hypercholesterolaemia could retard the atherosclerotic process. Given that CHD and hypercholesterolaemia cluster within families, a screening strategy based on a family history of vascular disease has been advocated. Serum total cholesterol concentrations were measured in a random stratified sample of 1012 children aged from 12-15 years old participating in a coronary risk factor surveillance study in Northern Ireland. Information about vascular disease in close family members was obtained by means of a questionnaire. The study population was divided into two groups according to total cholesterol values: (i) normal, < 5.2 mmol/l (n = 822) and (ii) raised, > or = 5.2 mmol/l (n = 190). A family history identified 63 out of 190 individuals with hypercholesterolaemia yielding a sensitivity of 33.2% and specificity of 71.5%. Our data indicated that a strategy whereby only children from high risk families are screened for hypercholesterolaemia is ineffective. While primary prevention emphasising a healthy diet for all is essential, the role of universal screening deserves further appraisal.
高胆固醇血症是冠心病（CHD）发生的主要危险因素。早期发现和管理高胆固醇血症可延缓动脉粥样硬化进程。鉴于冠心病和高胆固醇血症在家族中聚集，有人主张基于血管疾病家族史制定筛查策略。在北爱尔兰一项冠心病危险因素监测研究中，对1012名12至15岁儿童的随机分层样本测量了血清总胆固醇浓度。通过问卷调查获取了近亲中血管疾病的信息。根据总胆固醇值将研究人群分为两组：（i）正常，<5.2 mmol/l（n = 822）和（ii）升高，>或= 5.2 mmol/l（n = 190）。家族史在190例高胆固醇血症患者中识别出63例，敏感性为33.2%，特异性为71.5%。我们的数据表明，仅对高危家庭的儿童进行高胆固醇血症筛查的策略是无效的。虽然强调全民健康饮食的一级预防至关重要，但普遍筛查的作用值得进一步评估。
