Martínez G, Quiñones S, Castillo L, Ramos A, Avellana E, Ciurana R, Mata M
Unidad Docente de MFyC de Barcelona, Institut Català de la Salut.
Aten Primaria. 1996 Sep 15;18(4):176-81.
To evaluate whether hypolipaemiant treatment in patients with hypercholesterolaemia (HC) corresponds to the recommendations in a primary care diagnosis and treatment protocol.
Descriptive observational study.
Primary care centre.
304 patients whose long-term prescription records recorded hypolipaemiant drugs.
Average age was 62.7 and 198 were women. 176 presented simple HC and 125 mixed dyslipaemia. 46 had a history of ischaemic cardiopathy. Pre-treatment LDL-cholesterol (LDL-c) was recorded for 224; 168 of them had 2 or more cardiovascular risk factors. Of the 202 who had a record of post-treatment LDL-c, 163 were at level III of risk, which went down to 47 at 6 months. The values before and after medication were as follows: total cholesterol (TC) 290.3 mg/dl and 246.2 mg/dl; LDL-c 207.8 mg/dl and 166.0 mg/dl; HDL-cholesterol 50.5 mg/dl and 53.1 mg/dl; and triglycerides (TG) 156.1 mg/dl and 133.6 mg/dl. Mean reduction of TC and LDL-c was greater in the patients treated with statins that in those treated with fibrates. Decrease in TG was greater with fibrates.
Treatment was initiated when LDL-c figures were over the limit specified in the protocol. In most cases this was because of the accumulation of cardiovascular risk factors.
评估高胆固醇血症（HC）患者的降血脂治疗是否符合初级保健诊断与治疗方案中的建议。
描述性观察研究。
初级保健中心。
304名长期处方记录中有降血脂药物的患者。
平均年龄为62.7岁，女性198名。176例为单纯高胆固醇血症，125例为混合性血脂异常。46例有缺血性心脏病史。记录了224例患者治疗前的低密度脂蛋白胆固醇（LDL-c）；其中168例有2种或更多心血管危险因素。在有治疗后LDL-c记录的202例患者中，163例处于风险三级，6个月时降至47例。用药前后的值如下：总胆固醇（TC）290.3mg/dl和246.2mg/dl；LDL-c 207.8mg/dl和166.0mg/dl；高密度脂蛋白胆固醇50.5mg/dl和53.1mg/dl；甘油三酯（TG）156.1mg/dl和133.6mg/dl。他汀类药物治疗的患者TC和LDL-c的平均降低幅度大于贝特类药物治疗的患者。贝特类药物使TG的降低幅度更大。
当LDL-c数值超过方案规定的限值时开始治疗。在大多数情况下，这是由于心血管危险因素的累积。
