LDL-C<1.4 mmol/L,且降幅要≥50%!中国医师协会ACS血脂管理临床路径专家共识

2020-10-30 MedSci MedSci

血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。

血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。

近日,中国医师协会血管内科医师分会发布了急性冠状动脉综合征患者血脂管理临床路径专家共识

调脂干预靶目标

 

 

共识建议,急性冠脉综合征患者二级预防,推荐坏胆固醇(LDL-C)水平<1.8 mmol/L,且较基线水平降幅≥50%。

急性冠脉综合征合并高风险因素患者调脂治疗目标值为LDL-C<1.4 mmol/L,且较基线水平降幅≥50%。

高风险因素包括:复发性动脉粥样硬化性心血管事件;冠状动脉多支血管病变;糖尿病;心、脑或外周多血管床动脉粥样硬化性心血管病;LDL-C水平≥ 4.9 mmol/L。

建议筛查急性冠脉综合征患者的Lp(a)水平,Lp(a)水平升高者应进行血脂管理。

共识建议的急性冠脉综合征合并高风险因素人群,与中国胆固醇教育计划调脂治疗降低心血管事件专家建议(2019)中的超高危人群人群类似。

1、急性冠脉综合征合并高风险因素患者的血脂管理

急性冠脉综合征合并高风险因素患者急需进行强化血脂管理,故本共识仅就该类患者制定了血脂管理路径。

2、急性冠脉综合征未合并高风险因素患者的血脂管理

入院时LDL-C水平<1.8 mmol/L,若入院前规律服用他汀(4周及以上),建议加强饮食等生活方式干预,同时根据实际情况调整用药;若未规律服用他汀,建议给予他汀治疗。

LDL-C水平在1.8~3.4 mmol/L范围者,若入院前规律服用他汀,建议联用其他降脂药物(如依折麦布或PCSK9抑制剂);若未规律服用他汀,则给予他汀单药治疗。

LDL-C水平>3.4 mmol/L者,建议他汀单药或者他汀联合非他汀类降脂药物[依折麦布和(或)PCSK9抑制剂]。

3、他汀不耐受患者:推荐直接启用非他汀类降脂药物

他汀不耐受需符合以下标准:

(1) 不能耐受至少两种他汀,其中一种为每日使用最低起始剂量的他汀,另一种为任何剂量的他汀;

(2) 他汀治疗后出现不适或实验室检测异常结果;

(3) 他汀相关不良反应是可逆的,减少剂量或停用症状得到缓解或改善,再次用药又可出现。

对于他汀不耐受患者,推荐直接启用非他汀类降脂药物。

4、中等强度他汀为常用给药强度

一般推荐中等强度他汀为我国急性冠脉综合征患者血脂管理的常用给药强度。

对于联合用药患者,应当密切关注其用药安全性问题,随访时常规监测肝酶、肌酶升高的情况。

对于PCSK9抑制剂,推荐阿利西尤单抗或依洛尤单抗。

对于合并甘油三酯升高患者,推荐使用贝特类、烟酸类药物或者ω-3脂肪酸药物来降低甘油三酯水平。

对于Lp(a)水平升高(≥30mg/dl)且LDL-C水平≥1.8 mmol/L(70 mg/dl)的患者,已规律使用他汀仍未达标,可优先联用PCSK9抑制剂治疗。

5、用药调整和治疗时长

当调整降脂药物种类或剂量时,都应在治疗4~6周内复查血脂水平,并依据达标情况再次调整治疗方案。

如LDL-C水平<0.4 mmol/L,应依据实际情况调整用药,并且密切关注血脂变化情况。

考虑到患者LDL-C水平需长期达标,为避免降脂效果反弹,应根据各种药物对LDL-C水平的降低幅度来考虑停药顺序。

降脂以及预防心血管事件再发需长期持续用药。

急性冠脉综合征患者出院后,建议每隔4~6周随访1次;此后,若无特殊情况且血脂达标,可改为每6~12个月随访1次。随访检查项目主要包括血脂、肝功能、肌酸激酶等。

共识指出,对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。

而且患者教育以及基于循证医学的心脏康复应贯穿整个治疗过程,可定期或根据需要进行个体化安排,有针对性地解决问题。

来源:

[1]中国医师协会心血管内科医师分会.急性冠状动脉综合征患者血脂管理临床路径专家共识. 中国循环杂志,2020,35:941-947. DOI:10.3969/j.issn.1000-3614.2020.10.001.

[2]中国胆固醇教育计划调脂治疗降低心血管事件专家建议(2019). 中华内科杂志,2020,59(1): 18-22.

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  3. [GetPortalCommentsPageByObjectIdResponse(id=1845831, encodeId=ed29184583130, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sun Aug 15 19:30:17 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1977346, encodeId=934a19e73461f, content=<a href='/topic/show?id=d7e321e287d' target=_blank style='color:#2F92EE;'>#中国医师#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21728, encryptionId=d7e321e287d, topicName=中国医师)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Mon Nov 02 19:30:17 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946940, encodeId=f5c9946940cc, content=学习了,血脂管理是一项重要的任务,总是被忽略, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed292155573, createdName=1201ef31m54暂无昵称, createdTime=Tue Mar 09 22:39:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663162, encodeId=bb2016631623c, content=<a href='/topic/show?id=fff221e29fd' target=_blank style='color:#2F92EE;'>#中国医师协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21729, encryptionId=fff221e29fd, topicName=中国医师协会)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ce25527825, createdName=ms6897892027066920, createdTime=Thu Dec 31 14:30:17 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896631, encodeId=dfc58966316f, content=血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 03 15:31:38 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896544, encodeId=0bd389654451, content=对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae205385871, createdName=Lexi, createdTime=Tue Nov 03 10:45:55 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279353, encodeId=180812e935331, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422592, encodeId=f38a1422592a7, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895650, encodeId=117489565080, content=血脂异常是动脉粥样硬化最重要的危险因素之一。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Fri Oct 30 16:04:54 CST 2020, time=2020-10-30, status=1, ipAttribution=)]
    2021-03-09 1201ef31m54暂无昵称

    学习了,血脂管理是一项重要的任务,总是被忽略

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1845831, encodeId=ed29184583130, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sun Aug 15 19:30:17 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1977346, encodeId=934a19e73461f, content=<a href='/topic/show?id=d7e321e287d' target=_blank style='color:#2F92EE;'>#中国医师#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21728, encryptionId=d7e321e287d, topicName=中国医师)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Mon Nov 02 19:30:17 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946940, encodeId=f5c9946940cc, content=学习了,血脂管理是一项重要的任务,总是被忽略, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed292155573, createdName=1201ef31m54暂无昵称, createdTime=Tue Mar 09 22:39:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663162, encodeId=bb2016631623c, content=<a href='/topic/show?id=fff221e29fd' target=_blank style='color:#2F92EE;'>#中国医师协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21729, encryptionId=fff221e29fd, topicName=中国医师协会)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ce25527825, createdName=ms6897892027066920, createdTime=Thu Dec 31 14:30:17 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896631, encodeId=dfc58966316f, content=血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 03 15:31:38 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896544, encodeId=0bd389654451, content=对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae205385871, createdName=Lexi, createdTime=Tue Nov 03 10:45:55 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279353, encodeId=180812e935331, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422592, encodeId=f38a1422592a7, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895650, encodeId=117489565080, content=血脂异常是动脉粥样硬化最重要的危险因素之一。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Fri Oct 30 16:04:54 CST 2020, time=2020-10-30, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1845831, encodeId=ed29184583130, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sun Aug 15 19:30:17 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1977346, encodeId=934a19e73461f, content=<a href='/topic/show?id=d7e321e287d' target=_blank style='color:#2F92EE;'>#中国医师#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21728, encryptionId=d7e321e287d, topicName=中国医师)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Mon Nov 02 19:30:17 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946940, encodeId=f5c9946940cc, content=学习了,血脂管理是一项重要的任务,总是被忽略, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed292155573, createdName=1201ef31m54暂无昵称, createdTime=Tue Mar 09 22:39:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663162, encodeId=bb2016631623c, content=<a href='/topic/show?id=fff221e29fd' target=_blank style='color:#2F92EE;'>#中国医师协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21729, encryptionId=fff221e29fd, topicName=中国医师协会)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ce25527825, createdName=ms6897892027066920, createdTime=Thu Dec 31 14:30:17 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896631, encodeId=dfc58966316f, content=血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 03 15:31:38 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896544, encodeId=0bd389654451, content=对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae205385871, createdName=Lexi, createdTime=Tue Nov 03 10:45:55 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279353, encodeId=180812e935331, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422592, encodeId=f38a1422592a7, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895650, encodeId=117489565080, content=血脂异常是动脉粥样硬化最重要的危险因素之一。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Fri Oct 30 16:04:54 CST 2020, time=2020-10-30, status=1, ipAttribution=)]
    2020-11-03 咻凡

    血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1845831, encodeId=ed29184583130, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sun Aug 15 19:30:17 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1977346, encodeId=934a19e73461f, content=<a href='/topic/show?id=d7e321e287d' target=_blank style='color:#2F92EE;'>#中国医师#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21728, encryptionId=d7e321e287d, topicName=中国医师)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Mon Nov 02 19:30:17 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946940, encodeId=f5c9946940cc, content=学习了,血脂管理是一项重要的任务,总是被忽略, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed292155573, createdName=1201ef31m54暂无昵称, createdTime=Tue Mar 09 22:39:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663162, encodeId=bb2016631623c, content=<a href='/topic/show?id=fff221e29fd' target=_blank style='color:#2F92EE;'>#中国医师协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21729, encryptionId=fff221e29fd, topicName=中国医师协会)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ce25527825, createdName=ms6897892027066920, createdTime=Thu Dec 31 14:30:17 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896631, encodeId=dfc58966316f, content=血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 03 15:31:38 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896544, encodeId=0bd389654451, content=对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae205385871, createdName=Lexi, createdTime=Tue Nov 03 10:45:55 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279353, encodeId=180812e935331, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422592, encodeId=f38a1422592a7, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895650, encodeId=117489565080, content=血脂异常是动脉粥样硬化最重要的危险因素之一。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Fri Oct 30 16:04:54 CST 2020, time=2020-10-30, status=1, ipAttribution=)]
    2020-11-03 Lexi

    对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1845831, encodeId=ed29184583130, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sun Aug 15 19:30:17 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1977346, encodeId=934a19e73461f, content=<a href='/topic/show?id=d7e321e287d' target=_blank style='color:#2F92EE;'>#中国医师#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21728, encryptionId=d7e321e287d, topicName=中国医师)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Mon Nov 02 19:30:17 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946940, encodeId=f5c9946940cc, content=学习了,血脂管理是一项重要的任务,总是被忽略, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed292155573, createdName=1201ef31m54暂无昵称, createdTime=Tue Mar 09 22:39:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663162, encodeId=bb2016631623c, content=<a href='/topic/show?id=fff221e29fd' target=_blank style='color:#2F92EE;'>#中国医师协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21729, encryptionId=fff221e29fd, topicName=中国医师协会)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ce25527825, createdName=ms6897892027066920, createdTime=Thu Dec 31 14:30:17 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896631, encodeId=dfc58966316f, content=血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 03 15:31:38 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896544, encodeId=0bd389654451, content=对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae205385871, createdName=Lexi, createdTime=Tue Nov 03 10:45:55 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279353, encodeId=180812e935331, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422592, encodeId=f38a1422592a7, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895650, encodeId=117489565080, content=血脂异常是动脉粥样硬化最重要的危险因素之一。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Fri Oct 30 16:04:54 CST 2020, time=2020-10-30, status=1, ipAttribution=)]
    2020-11-01 yaanren
  8. [GetPortalCommentsPageByObjectIdResponse(id=1845831, encodeId=ed29184583130, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sun Aug 15 19:30:17 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1977346, encodeId=934a19e73461f, content=<a href='/topic/show?id=d7e321e287d' target=_blank style='color:#2F92EE;'>#中国医师#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21728, encryptionId=d7e321e287d, topicName=中国医师)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Mon Nov 02 19:30:17 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946940, encodeId=f5c9946940cc, content=学习了,血脂管理是一项重要的任务,总是被忽略, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed292155573, createdName=1201ef31m54暂无昵称, createdTime=Tue Mar 09 22:39:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663162, encodeId=bb2016631623c, content=<a href='/topic/show?id=fff221e29fd' target=_blank style='color:#2F92EE;'>#中国医师协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21729, encryptionId=fff221e29fd, topicName=中国医师协会)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ce25527825, createdName=ms6897892027066920, createdTime=Thu Dec 31 14:30:17 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896631, encodeId=dfc58966316f, content=血脂异常是动脉粥样硬化最重要的危险因素之一。然而,我国急性冠脉综合征患者的血脂管理状况并不理想,达标率不足。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 03 15:31:38 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896544, encodeId=0bd389654451, content=对急性冠脉综合征患者长期血脂管理认知不足是导致其血脂达标率低、治疗依从性差的主要原因,对患者和(或)陪护人员进行健康教育并且协助患者改变不良的生活行为、做好二级预防尤为必要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae205385871, createdName=Lexi, createdTime=Tue Nov 03 10:45:55 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279353, encodeId=180812e935331, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422592, encodeId=f38a1422592a7, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Sun Nov 01 04:30:17 CST 2020, time=2020-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895650, encodeId=117489565080, content=血脂异常是动脉粥样硬化最重要的危险因素之一。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Fri Oct 30 16:04:54 CST 2020, time=2020-10-30, status=1, ipAttribution=)]
    2020-11-01 zhwj
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    2020-10-30 咻凡

    血脂异常是动脉粥样硬化最重要的危险因素之一。

    0

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