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[拉里奥哈初级保健中血脂异常的检测策略]

[Strategies for the detection of dyslipemias in primary care in La Rioja].

作者信息

Brea Hernando A J, Villar Arias M A, Mosquera Lozano J D, Ramírez Alesón M V, Jiménez Gómez M E

机构信息

Servicio de Medicina Interna, Hospital San Millán, Logroño, La Rioja.

出版信息

An Med Interna. 1996 May;13(5):227-31.

PMID:8767869
Abstract

We was carried out a survey between all primary care physicians (PCP) of La Rioja on their social and demographic data, anamnesis on their factors of cardiovascular risk and behavior in the strategies of hypercholesterolemia detection. The 65% of the PCP ask to their patient on knowledge of their cholesterol; this proportion increases between the physicians that know the recommendations of the Spanish Atherosclerosis Society (SAS) (p < 0.002). The 100% of the PCP determine some lipid parameter when they specify a blood sample for another reason or in presence of arterial hypertension, coronary heart disease, dyslipidemias or diabetes mellitus. In presence af smoking habit or oral contraceptive use, PCP that know the SAS or that they work in the rural environment, respectively, they solicit lipid parameters with a greater frequency (p < 0.04 and p < 0.03). Only a 23% of the PCP carry out electrocardiogram in case of a hyperlipidemia, percentage that is incremented between those that works in primary health centers ar in the urban medium (p < 0.03 and p < 0.03). A quarter af the PCP don't refer to the specialized attention to their patients with uncontrolled dyslipidemia and almost the 10% they would not send them under no circumstance. Although in general seem us adequate the behavior in opportunist detection of the PCP, this improves up on knowing the normative of national consensus.

摘要

我们对拉里奥哈地区的所有初级保健医生(PCP)进行了一项关于其社会和人口统计学数据、心血管风险因素的问诊以及高胆固醇血症检测策略中的行为的调查。65%的初级保健医生会询问患者对自身胆固醇的了解情况;在了解西班牙动脉粥样硬化学会(SAS)建议的医生中,这一比例有所增加(p < 0.002)。当出于其他原因采集血样或患者存在动脉高血压、冠心病、血脂异常或糖尿病时,100%的初级保健医生会测定一些血脂参数。在患者有吸烟习惯或使用口服避孕药的情况下,分别了解SAS建议的初级保健医生或在农村环境工作的初级保健医生,更频繁地要求测定血脂参数(p < 0.04和p < 0.03)。在高脂血症患者中,只有23%的初级保健医生会进行心电图检查,在初级保健中心工作或在城市中等地区工作的医生中这一比例有所增加(p < 0.03和p < 0.03)。四分之一的初级保健医生不会将血脂控制不佳的患者转诊至专科治疗,近10%的医生在任何情况下都不会转诊。尽管总体而言,初级保健医生在机会性检测方面的行为似乎是适当的,但在了解国家共识规范后会有所改善。

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