Except for a few secondary dyslipidemia caused by systemic diseases, the vast majority of dyslipidemia is caused by heredityGenetic defectOr withenvironmental factorPrimary dyslipidemia caused by interaction.
1. Genetic factors
Primary dyslipidemia is caused by genetic defects or interaction with environmental factors.
2. Lifestyle
Including overeating, alcoholism, food preference, irregular diet, etcBad eating habitsAnd lack ofphysical activity, nervous, irregular life, etc.
(2) Primary hyperlipidemiaPrimary hyperlipidemia can be diagnosed after secondary hyperlipidemia is excluded.It is known that some of the primary hyperlipidemia is caused by congenital gene defects, while the etiology of the other part of primary hyperlipidemia is still unclear.
2. Typing
(1) Classification of hyperlipoproteinemiaThe World Health Organization (WHO) has formulated the classification of hyperlipoproteinemia, which is divided into 6 types, such as type I, type IIa, type IIb, type III, type IV and type V.This classification method is very helpful for guiding clinical diagnosis and treatment of hyperlipidemia, but it also existsdeficienciesThe most obvious disadvantage is that it is too complicated.
(3) GenotypingWith the rapid development of molecular biology, people's understanding of hyperlipidemia has gradually deepened to the gene level.It has been found that a considerable number of hyperlipidemia patients have single or multiplegenetic genesDefects.Hyperlipidemia caused by gene defect is characterized by familial accumulation and obvious genetic tendency, so it is usually calledFamilial hyperlipidemia。
lipidXanthoma caused by deposition in the dermis.The patient may have xanthoma planum, xanthoma palmatum, xanthoma tendon and xanthoma palmatumTuberous xanthoma。
Lipid deposition in vascular endotheliumatherosclerosis, coronary heart disease and peripheral vascular disease.
Xanthoma due to dyslipidemiaincidence rateIt is not very high. The occurrence and development of atherosclerosis takes a long time, so most patients with dyslipidemia have no symptoms and abnormal signs.However, patients with abnormal blood lipids are often undergoing blood biochemical tests (measurementBlood cholesterolandtriglyceride）It was discovered when.
(2) Observe whether the patient has xanthoma, palpate whether there is liverSplenomegaly。Check the patient's joints, and determine whether there is a diagnosis based on the medical historyVagrancyPolyarthritis.
2. Laboratory inspection
There are many items to detect blood lipids clinically, and the basic items are total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol.
(1) Plasma appearance inspectionIt can judge the content of chyle particles (mainly containing triglycerides) in plasma.
(2) Lipoprotein electrophoresis methodIt can be divided into four lipoproteins: chyle microparticles, pre - β, β and α.
(3) Ultracentrifugation methodIt can distinguish chyle particles, very low density lipoproteinIntermediate density lipoprotein, low-density lipoprotein and high-density lipoprotein.
(4) Determination of blood cholesterol and triglyceridesIt should be carried out 9~12 hours after fasting.
(1) It should be based on whether there is coronary heart disease or coronary heart disease and whether there iscardiovascularRisk factorsAnd comprehensively evaluate the blood lipid level to determineTreatment measuresAnd the target level of blood lipids.
(2) Diet therapy and lifestyle improvement are the basic measures for the treatment of dyslipidemia.No matter whether drug lipid regulation treatment is carried out or not, diet control and lifestyle improvement must be adhered to.
(3) Select appropriate lipid regulating drugs according to the type of dyslipidemia and the purpose of treatment.It is necessary to regularly carry out the lipid regulating effect andAdverse drug reactionsMonitoring of.
(4) When deciding to use drugs for lipid-lowering treatment, it is necessary to fully understand the patient's coronary heart disease and associated risk factors.During lipid regulation treatmentLow density lipoprotein cholesterolAs the primary goal.
(2) Choose foods that can reduce LDL cholesterol (e.gPhytosterolSoluble fiber).
(3) Lose weight.
(4) Increase regular physical activity.
(5) Take measures against othersRisk factors of cardiovascular diseaseMeasures such as smoking cessation, salt restriction to reduce blood pressure, etc.
(1) StatinsStatinsCan significantly reducetotal cholesterolAnd low-density lipoprotein cholesterol, also reduce triglyceride levels and slightly increase high-density lipoprotein cholesterol.In addition, statins may also have anti-inflammatory and protective effects on vascular endothelium.In the past 20 yearsclinical research Statins are currently used to prevent and treat hypercholesterolemia and atherosclerosisSexual diseasesVery important medicine.Common statins include:lovastatin、Simvastatin、Pravastatin、FluvastatinandAtorvastatinEtc.
In addition, domestic traditional Chinese medicineXuezhikang CapsuleIt contains a variety of natural statins, mainly lovastatin.
Adhere to proper exercise, such as joggingWuqinxi, Taijiquan, table tennis, disco for the elderly, etc.Usually participatephysical labor, weight gain should be controlled.
4. Drink tea moderately
Contained in teaCatechuic acidWith enhanced blood vesselsflexibility, elasticity andPermeabilityThe effect ofAngiosclerosis。TeatheophyllineandcaffeineIt can excite spirit, promote blood circulation, reduce fatigue and has diuretic effect.Drinking tea in moderation can eliminate greasy diet and lose weight.
