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成人高胆固醇血症查出、评估和治疗专家委员会的第三个报告(adult treatment panel,ATPⅢ)发表后3年,5项大规模的临床试验结果陆续发表面世。全国胆固醇宣教规划(national cholesterol education plan.NCEP)专家们密切注视行内动态,及时、客观地回应他们的新见解。经过细察慎思.写成文告《全国胆固醇宣教规划报告:最近几项临床试验对ATPⅢ的启示》,对各试验的主要结果和观点,给予扼要的阐释、评议,并提出共识性建议。对历经验证、实效确凿的治疗高脂血症的生活方式等,再三强调,而根据新的临床试验结果提出的建议强调:对十分高危者,可根据临床判断和病人的意愿选择采用。但目前,保护心脏研究(heart protection study,HPS)和普伐他汀对老人安全性的评估(prospective study of pravastatin in the elderly at risk.PROVE-IT)调脂至小于2.6mmol/L(100mg/dL)的裨益还未足以定论,还有几项将低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)降至很低水平的临床试验正在进行中,还需要经过目前进行中、同样设计的其他临床试验的证实,才能提出对低LDL-C的高危病人治疗的全面、完整的建议。说明作者们正在等待积累更多证据。反映了报告作者们的谨慎态度和笃实为学精神。对疾病的斗争素无国界。我们自当认真吸取全人类的智慧。缘于这一课题本身的复杂性,上述进行中的几项临床试验结果又不应妄断。又缘于我们有异于西方的特点,本本主义不可取,包括洋本本。照搬既然不可取,如何做到高胆固醇血症治疗的规范化和本土化?我们热切期待我国心血管界的智者联起手来,咀嚼这些资料,独立思考,用我国自己的底蕴考累,联系到医疗、社会、科研的方方面面,凝聚出我们自己的共识,提出既能容纳百家,又贴近我们的实际的治疗方案。
Three years after the publication of the third report of the Expert Committee on the Diagnosis, Evaluation and Treatment of Adult Hypercholesterolemia (ATP III), five large-scale clinical trial results have been published. National cholesterol education plan (NCEP) experts keep a close watch on the dynamics in the industry and respond to their new insights in a timely and objective manner. After careful consideration, written into the report “National Cholesterol mission planning report: the recent clinical trials of ATP Ⅲ revelation”, the main results of each experiment and viewpoints, give a concise explanation, comments, and put forward consensus recommendations. On the proven and practical treatment of hyperlipidemic lifestyles, etc., repeatedly stressed, and based on the results of the new clinical recommendations put forward: the very high risk, according to clinical judgment and the patient’s choice to adopt. However, at present, the prospective study of pravastatin in the elderly at risk. Prove-IT is lipid-lowering to less than 2.6 mmol / L (100 mg / dL ) Are not yet conclusive, and there are several other clinical trials that have been done to bring low-density lipoprotein cholesterol (LDL-C) down to a very low level and are going through the same process Of other clinical trials confirmed in order to put forward a comprehensive and complete recommendations for the treatment of high-risk patients with low LDL-C. The authors are waiting to accumulate more evidence. It reflects the cautiousness of the report authors and the spirit of being true to their studies. There is no border to the disease. We should earnestly learn the wisdom of all mankind. Due to the complexity of the subject itself, the results of several of the ongoing clinical trials should not be taken absurdly. And because we are different from the characteristics of the West, the capitalism is not desirable, including the capital books. Since it is not desirable, how to achieve the standardization and localization of hypercholesterolemia? We are eagerly looking forward to join hands with the wise men of the cardiovascular community in our country to chew these materials, to think independently and to use our own experience to contact with Medical treatment, social science and research. We have come up with our own consensus and proposed an actual treatment plan that can accommodate hundreds and close to us.