ESCEAS血脂异常管理指南简介CV-1109-CR-0178—培训课件.ppt

* 血脂异常是病因，其他是危险因素，其他是促进动脉粥样硬化；血脂异常是必备的，是必需。 * 。 * 12个部分 * SCORE评分考虑的五大要素是：性别，年龄，吸烟，收缩压和总胆固醇。 * A particular problem relates to young people with high levels of risk factors; a low absolute risk may conceal a very high relative risk requiring intensive lifestyle advice. Therefore, a relative risk chart has been added to the absolute risk charts to illustrate that, particularly in younger persons, lifestyle changes can reduce relative risk substantially as well as reducing the increase in absolute risk that will occur with ageing (Figure 3). * * 12个部分 * 该表的设计部分参考了2007年ESC/ESH的高血压指南的模式，也是按照危险因素分层和基线血压水平推荐的干预策略。 * The Cholesterol Treatment Trialists (CTT) Collaboration was established in 1994 after it was identified that no single ongoing trial would have sufficient statistical power to address some key uncertainties about the effects of lowering cholesterol. It was recognised that, while the individual trials might be large enough to demonstrate effects on the aggregate of all coronary events, they might well over- or underestimate any effects on coronary death or on other specific vascular or non-vascular outcomes, especially when particular subgroups of participants were considered. Hence, it was planned to conduct periodic meta-analyses of individual participant data on mortality and morbidity from all relevant large-scale randomised trials of lipid-modifying treatments whose first results would appear subsequently (see published protocol1). * 主要血管事件：首次发生的主要冠脉事件、冠脉重建或卒中 1.8是上限，并非下限 * 与2004 NCEP ATP III指南相似，2007年中国成人血脂异常防治指南中高危及极高危患者LDL-C治疗目标值也均更低。对于高危患者推荐LDL-C ＜ 100mg/dL(2.59mmol/L)，对于极高危患者推荐LDL-C ＜ 80mg/dl (2.07mmol/L)。 * 除了血脂异常指南外，2009加拿大血脂异常和心血管疾病预防指南中推荐，高危的血脂异常患者降低 LDL-C2 mmol/L 或≥50%。 * * 1.8是上限，并非下限 * * 12个部分 * 饱和β一谷甾烷醇和β-谷甾醇阻碍胆固醇吸收效果与摄取胆固醇的量有密切关系。只有当每天摄入的胆固醇量高于400—450毫克时甾醇和甾烷醇才会表现出对胆固醇（包括膳食中及内源性胆固醇）吸收的阻碍。植物甾醇降胆固醇功能的作用机理主要有几种主要的理论。第一，植物甾醇和植物甾烷醇可以将小肠中的胆固醇沉淀下来，使其呈现不溶解状态，因此不能被吸收。第二，胆固醇能溶解于小肠内脏的胆汁酸微胶束（主要由胆汁盐和磷脂组成）是被吸收的必要条件。而植物甾醇的存在可以将胆固醇替换出来，使之不能经胆汁酸胶束的运送到