2011ESCEAS血脂指南近年原文.ppt

一、CVD风险评估二、危险分层与降脂目标血脂治疗策略血脂异常的治疗LifestyleinterventionDrugforhypercholesterolaemia1、statin2、Bileacidsequestrants3、Cholesterolabsorptioninhibitors4、NicotinicacidDrugforhypertriglyceridaemia1、Fibrates2、Nicotinicacid3、n-3fattyacids海军总医院心脏中心DepartmentofCardiology,PLANavyGeneralHospitalESC/EASGuidelinesforthemanagementofdyslipidaemias----2011欧洲血脂指南解读Thelowrisk：BelgiumFranceGreeceItalyLuxembourgSpainSwitzerlandPortugalThehighriskchartsshouldbeconsideredinallothercountriesofEurope.（一）极高危组--中国指南（2007）1.急性冠脉综合征2.缺血性心血管病合并糖尿病（一）极高危组-欧洲指南1、DocumentedCVDbyinvasiveornon-invasivetesting(suchascoronaryangiography,nuclearimaging,stressechocardiography,carotidplaqueonultrasound),previousmyocardialinfarction(MI),ACS,coronaryrevascularization[percutaneouscoronaryintervention(PCI),coronaryarterybypassgraft(CABG)]andotherarterialrevascularizationprocedures,ischaemicstroke,PAD.2、Patientswithtype2diabetes,patientswithtype1diabeteswithtargetorgandamage(suchasmicroalbuminuria).3、PatientswithmoderatetosevereCKD[glomerularfiltrationrate(GFR)60mL/min/1.73m2).4、Acalculated10yearriskSCORE≥10%.一、极高危组-降脂目标欧洲指南LDL-C1.8mmol/L(70mg/dl)和/或使LDL-C降低≥50%中国指南LDL-C2.07mmol/L(80mg/dl)二、高危组--中国指南1.冠心病2.冠心病等危症3.10年危险性10-15%二、高危组-欧洲指南1.Markedlyelevatedsingleriskfactorssuchasfamilialdyslipidaemiasandseverehypertension.2.AcalculatedSCORE≥5%and10%for10yearriskoffatalCVD.二、高危组降脂目标值欧洲指南LDL-C2.5mmol/L(100mg/dl)中国指南LDL-C2.5mmol/L(100mg/dl)三、中危组-中国指南10年危险性5-10%三、中危组-欧洲指南SubjectsareconsideredtobeatmoderateriskwhentheirSCOREis≥1%and5%at10years.Manymiddle-agedsubjectsbelongtothisriskcategory.ThisriskisfurthermodulatedbyafamilyhistoryofprematureCAD,abdominalobesity,physicalactivitypattern,HDL-C