{"id":46467,"date":"2025-01-16T05:11:03","date_gmt":"2025-01-16T05:11:03","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=46467"},"modified":"2025-01-16T05:11:03","modified_gmt":"2025-01-16T05:11:03","slug":"%e3%80%90%e8%a7%84%e8%8c%83%e4%b8%8e%e6%8c%87%e5%8d%97%e3%80%91%e7%b3%96%e5%b0%bf%e7%97%85%e6%82%a3%e8%80%85%e8%a1%80%e8%84%82%e7%ae%a1%e7%90%86%e4%b8%ad%e5%9b%bd%e4%b8%93%e5%ae%b6%e5%85%b1%e8%af%86","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=46467","title":{"rendered":"\u3010\u89c4\u8303\u4e0e\u6307\u5357\u3011\u7cd6\u5c3f\u75c5\u60a3\u8005\u8840\u8102\u7ba1\u7406\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6\uff082024\u7248\uff09"},"content":{"rendered":"

\u6587\u7ae0\u6765\u6e90\uff1a\u4e2d\u534e\u7cd6\u5c3f\u75c5\u6742\u5fd7,  2024, 16(4): 383-403.<\/p>\n

\u4f5c\u8005\uff1a\u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u5185\u5206\u6ccc\u4ee3\u8c22\u79d1\u533b\u5e08\u5206\u4f1a   \u56fd\u5bb6\u5fc3\u8840\u7ba1\u75c5\u4e13\u5bb6\u59d4\u5458\u4f1a\u5fc3\u8840\u7ba1\u4ee3\u8c22\u533b\u5b66\u4e13\u4e1a\u59d4\u5458\u4f1a <\/p>\n

\u901a\u4fe1\u4f5c\u8005\uff1a\u5468\u667a\u5e7f\uff0c\u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662\u4ee3\u8c22\u5185\u5206\u6ccc\u79d1 \u7cd6\u5c3f\u75c5\u514d\u75ab\u5b66\u6559\u80b2\u90e8\u91cd\u70b9\u5b9e\u9a8c\u5ba4 \u56fd\u5bb6\u4ee3\u8c22\u6027\u75be\u75c5\u4e34\u5e8a\u533b\u5b66\u7814\u7a76\u4e2d\u5fc3\uff0c\u957f\u6c99 410011\uff0cEmail\uff1azhouzhiguang@csu.edu.cn\uff1b\u5f6d\u9053\u6cc9\uff0c\u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662\u5fc3\u8840\u7ba1\u5185\u79d1\uff0c\u957f\u6c99 410011\uff0cEmail\uff1apengdq@csu.edu.cn<\/p>\n

\u6458\u8981<\/p>\n

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\u4e00\u3001T2DM\u60a3\u8005\u7684\u8840\u8102\u8c31\u7279\u70b9<\/p>\n

1.\u8840\u8102\u5f02\u5e38\u7684\u7279\u5f81\uff1aT2DM\u60a3\u8005\u7684\u8840\u8102\u8c31\u4ee5\u6df7\u5408\u578b\u8840\u8102\u7d0a\u4e71\u591a\u89c1\u3002\u5305\u62ec\uff1a\uff081\uff09\u7a7a\u8179\u548c\u9910\u540e\u9ad8\u7518\u6cb9\u4e09\u916f\uff08triglyceride\uff0cTG\uff09\u8840\u75c7\u4ee5\u53ca\u9ad8\u5bc6\u5ea6\u8102\u86cb\u767d\u80c6\u56fa\u9187\uff08high\u2011density lipoprotein cholesterol\uff0cHDL\u2011C\uff09\u6c34\u5e73\u964d\u4f4e\uff1b\uff082\uff09\u8840\u6e05\u603b\u80c6\u56fa\u9187\uff08total cholesterol\uff0cTC\uff09\u548c\u4f4e\u5bc6\u5ea6\u8102\u86cb\u767d\u80c6\u56fa\u9187\uff08low\u2011density lipoprotein cholesterol\uff0cLDL\u2011C\uff09\u6c34\u5e73\u6b63\u5e38\u6216\u8f7b\u5ea6\u5347\u9ad8\uff1b\uff083\uff09\u4f4e\u5bc6\u5ea6\u8102\u86cb\u767d\uff08low\u2011density lipoprotein\uff0cLDL\uff09\u9897\u7c92\u4e9a\u578b\u53d1\u751f\u6539\u53d8\uff0c\u5c0f\u800c\u5bc6\u4f4e\u5bc6\u5ea6\u8102\u86cb \u767d\uff08small dense low\u2011density lipoprotein\uff0csdLDL\uff09\u9897\u7c92\u589e\u52a0\uff3b3\u20115\uff3d<\/sup> \u3002<\/p>\n

2.\u8840\u8102\u5f02\u5e38\u7684\u4e3b\u8981\u539f\u56e0\uff1aT2DM\u60a3\u8005\u8840\u8102\u5f02\u5e38\u7684\u4e3b\u8981\u539f\u56e0\u5728\u4e8e\u5176\u5b58\u5728\u80f0\u5c9b\u7d20\u62b5\u6297\u3001\u80f0\u5c9b\u7d20\u76f8\u5bf9\u7f3a\u4e4f\u7b49\u5bfc\u81f4\u4f53\u5185\u6e38\u79bb\u8102\u80aa\u9178\u6c34\u5e73\u5347\u9ad8\uff0c\u809d\u810f\u5408\u6210\u6781\u4f4e\u5bc6\u5ea6\u8102\u86cb\u767d\uff08very low\u2011density lipoprotein\uff0cVLDL\uff09\u7684\u5e95\u7269\u589e\u52a0\uff0c\u540c\u65f6\u80f0\u5c9b\u7d20\u4f9d\u8d56\u6027\u8102\u86cb\u767d\u916f\u9176\uff08lipoprotein lipase\uff0cLPL\uff09\u6d3b\u6027\u4e0b\u964d\uff0cVLDL\u6e05\u9664\u51cf\u5c11\uff0c\u6700\u7ec8\u5bfc\u81f4 TG \u548c\u5bcc\u542b TG \u7684\u8102\u86cb\u767d\uff08triglyceride\u2011rich lipoprotein\uff0cTRL\uff09\u6c34\u5e73\u5347\u9ad8\u3002<\/p>\n

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\u4e8c\u3001T1DM\u60a3\u8005\u7684\u8840\u8102\u8c31\u7279\u70b9<\/p>\n

1.\u8840\u7cd6\u63a7\u5236\u4e0d\u4f73\u7684T1DM\u60a3\u8005\uff1a\u5176\u8840\u8102\u5f02\u5e38\u901a\u5e38\u4e0eT2DM\u60a3\u8005\u7c7b\u4f3c\uff0c\u8868\u73b0\u4e3a\u6df7\u5408\u578b\u8840\u8102\u7d0a\u4e71\uff0c\u4ee5\u7a7a\u8179\u548c\u9910\u540e\u9ad8TG\u8840\u75c7\u4e3a\u4e3b\uff0c\u540c\u65f6\u4f34\u6709HDL\u2011C\u6c34\u5e73\u964d\u4f4e\u53casdLDL\u6c34\u5e73\u5347\u9ad8\uff3b8\uff3d<\/sup> \u3002T1DM\u5e38\u4ee5\u7cd6\u5c3f\u75c5\u916e\u75c7\u9178\u4e2d\u6bd2\uff08diabetic ketoacidosis\uff0cDKA\uff09\u8d77\u75c5\u3002DKA \u53d1\u751f\u671f\u95f4\uff0c\u7531\u4e8e\u80f0\u5c9b\u7d20\u4e25\u91cd\u7f3a\u4e4f\uff0c\u53ef\u4ee5\u8868\u73b0\u4e3aTG\u6c34\u5e73\u663e\u8457\u5347\u9ad8\uff0c\u4f34\u968f HDL\u2011C \u548c LDL\u2011C \u6c34\u5e73\u4e0b\u964d\u3002\u8fd9\u4e9b\u8840\u8102\u5f02\u5e38\u7ecf\u5145\u5206\u7684\u80f0\u5c9b\u7d20\u6cbb\u7597\u540e\u53ef\u8fc5\u901f\u6062\u590d\u3002<\/p>\n

2.\u8840\u7cd6\u63a7\u5236\u826f\u597d\u7684T1DM\u60a3\u8005\uff1a\u7531\u4e8e\u957f\u671f\u4f7f\u7528\u5916\u6e90\u6027\u80f0\u5c9b\u7d20\u5bfc\u81f4\u5916\u5468\u9ad8\u80f0\u5c9b\u7d20\u8840\u75c7\u53ef\u5f15\u8d77LPL\u6d3b\u6027\u589e\u52a0\uff0cTG\u6c34\u5e73\u6b63\u5e38\u6216\u964d\u4f4e\uff0cHDL\u2011C\u6c34\u5e73\u6b63\u5e38\u6216\u5347\u9ad8\u3002\u9ad8\u80f0\u5c9b\u7d20\u8840\u75c7\u53ef\u80fd\u4e0a\u8c03LDL\u53d7\u4f53\uff0c\u4ece\u800c\u4fc3\u8fdbLDL\u7684\u6e05\u9664\uff0cLDL\u2011C\u6c34\u5e73\u53ef\u80fd\u4e0b\u964d\uff3b9\uff3d<\/sup> \u3002\u4f46\u90e8\u5206\u7814\u7a76\u663e\u793a\uff0cT1DM\u60a3\u8005\u5373\u4fbf\u8840\u7cd6\u63a7\u5236\u826f\u597d\uff0c\u5176sdLDL\u6c34\u5e73\u4ecd\u9ad8\u4e8e\u6b63\u5e38\u4eba\u7fa4\uff3b8\uff3d<\/sup> \u3002<\/p>\n

\u4e09\u3001\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u8840\u8102\u5f02\u5e38\u4e0eASCVD\u98ce\u9669<\/p>\n

1.LDL\u2011C\u6c34\u5e73\uff1a\u5728\u7cd6\u5c3f\u75c5\u60a3\u8005\u8840\u8102\u5f02\u5e38\u6240\u5e26\u6765\u7684\u5fc3\u8840\u7ba1\u98ce\u9669\u4e2d\uff0cLDL\u2011C\u662f\u516c\u8ba4\u7684\u9996\u8981\u5371\u9669\u56e0\u7d20\u30022008\u5e74\uff0c\u9488\u5bf9T2DM\u60a3\u8005\u7684UKPDS\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0cLDL\u2011C\u6c34\u5e73\u6bcf\u5347\u9ad81.0 mmol\/L\uff0cT2DM\u60a3\u8005\u7684\u51a0\u72b6\u52a8\u8109\u4e8b\u4ef6\u53d1\u751f\u98ce\u9669\u589e\u52a057%\uff3b10\uff3d<\/sup> \u30022016\u5e74\uff0c\u9488\u5bf9T1DM\u60a3\u8005\u7684DCCT\u7814\u7a76\u7ed3\u679c\u540c\u6837\u63d0\u793a\uff0c\u6821\u6b63\u5e74\u9f84\u548c\u7cd6\u5316\u8840\u7ea2\u86cb\u767d\uff08glycated hemoglobin A 1c<\/sub> \uff0cHbA 1c<\/sub> \uff09\u7b49\u5371\u9669\u56e0\u7d20\u540e\uff0cT1DM \u60a3\u8005\u7684 LDL\u2011C \u6c34\u5e73\u6bcf\u5347\u9ad80.56 mmol\/L\uff0c\u4e3b\u8981\u4e0d\u826f\u5fc3\u8840\u7ba1\u4e8b\u4ef6\uff08major adverse cardiovascular events\uff0cMACE\uff09\u53d1\u751f\u98ce\u9669\u589e\u52a07%\uff3b11\uff3d<\/sup> \u3002\u6b64\u5916\uff0c\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684 sdLDL\u6c34\u5e73\u5347\u9ad8\uff0csdLDL\u56e0\u5728\u8840\u6db2\u4e2d\u5faa\u73af\u65f6\u95f4\u957f\u3001\u66f4\u6613\u8fdb\u5165\u52a8\u8109\u8840\u7ba1\u5185\u819c\u4e0b\u5e76\u6ede\u7559\uff0c\u6700\u7ec8\u88ab\u5de8\u566c\u7ec6\u80de\u541e\u566c\u5f62\u6210\u6ce1\u6cab\u7ec6\u80de\uff0c\u56e0\u6b64\uff0csdLDL\u8f83LDL\u5177\u6709\u66f4\u5f3a\u7684\u81f4\u52a8\u8109\u7ca5\u6837\u786c\u5316\u4f5c\u7528\u3002<\/p>\n

2. \u975e HDL\u2011C \u6c34\u5e73\uff1a\u4e34\u5e8a\u6d41\u884c\u75c5\u5b66\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u9ad8TG\u8840\u75c7\u4e0e\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u52a8\u8109\u7ca5\u6837\u786c\u5316\u5bc6\u5207\u76f8\u5173\uff0c\u662f\u5fc3\u8840\u7ba1\u6b8b\u4f59\u98ce\u9669\u7684\u4e3b\u8981\u5371\u9669\u56e0\u7d20\u4e4b\u4e00\uff3b11\u201113\uff3d<\/sup> \u3002\u7cd6\u5c3f\u75c5\u60a3\u8005TG\u6c34\u5e73\u5347\u9ad8\u5b9e\u9645\u53cd\u6620\u7684\u662fTRL\u9897\u7c92\u589e\u52a0\u548c\u975eHDL\u2011C\u6c34\u5e73\u5347\u9ad8\uff0c\u800c\u975eHDL\u2011C\u4ee3\u8868\u4e86\u5168\u90e8\u81f4\u52a8\u8109\u7ca5\u6837\u786c\u5316\u8102\u86cb\u767d\u9897\u7c92\u4e2d\u7684\u80c6\u56fa\u9187\u3002\u65e2\u5f80\u7814\u7a76\u8868\u660e\uff0c\u975e HDL\u2011C \u6c34\u5e73\u8f83 LDL\u2011C \u6c34\u5e73\u80fd\u66f4\u597d\u5730\u9884\u6d4bASCVD\u98ce\u9669\uff3b14\uff3d<\/sup> \u3002\u4e00\u9879Meta\u5206\u6790\u7ed3\u679c\u63d0\u793a\uff0c\u975eHDL\u2011C\u6c34\u5e73\u4e0eT2DM\u60a3\u8005\u7684\u5fc3\u8840\u7ba1\u75be\u75c5\u98ce\u9669\u76f8\u5173\uff0c\u5728\u7537\u6027\u548c\u5973\u6027\u60a3\u8005\u4e2d\u7684 HR \u503c\u5206\u522b\u4e3a 1.98\uff0895%CI 1.70~2.30\uff09\u548c1.63\uff0895%CI 1.35~1.96\uff09\uff3b15\uff3d<\/sup> \u3002<\/p>\n

\u7cd6\u5c3f\u75c5\u60a3\u8005\u5408\u5e76ASCVD\u76f8\u5173\u8840\u8102\u5f02\u5e38\u7684\u6d41\u884c\u75c5\u5b66<\/p>\n

\u4e00\u3001T2DM\u60a3\u8005<\/p>\n

\u4e2d\u56fd T2DM\u60a3\u8005\u5408\u5e76\u8840\u8102\u5f02\u5e38\u7684\u6bd4\u4f8b\u9ad8\u4e8e\u666e\u901a\u4eba\u7fa4\uff0c\u540c\u65f6\u8840\u8102\u5f02\u5e38\u7684\u77e5\u6653\u7387\u3001\u6cbb\u7597\u7387\u3001\u8fbe\u6807\u7387\u4f4e\uff0c\u60a3\u8005\u5e38\u56e0\u81ea\u89c9\u75c7\u72b6\u4e0d\u660e\u663e\u800c\u672a\u5f97\u5230\u5145\u5206\u7684\u6cbb\u7597\u548c\u63a7\u5236\u3002\u5728\u8bc4\u4f30\u4e2d\u56fdT2DM\u60a3\u8005\u5fc3\u8840\u7ba1\u5371\u9669\u56e0\u7d20\u7684 CCMR\u20113B \u7814\u7a76\u4e2d\uff0c\u5bf9\u5168\u56fd 104 \u5bb6\u533b\u9662\u517125 817\u4f8b\u95e8\u8bca T2DM \u60a3\u8005\u7684\u8840\u8102\u5f02\u5e38\u8c03\u67e5\u7ed3\u679c\u663e\u793a\uff0c42% \u7684 T2DM \u60a3\u8005\u5408\u5e76\u8840\u8102\u5f02\u5e38\uff0c\u5176\u4e2d\u4ec5 55%\u63a5\u53d7\u4e86\u8c03\u8102\u6cbb\u7597\uff0c\u56db\u9879\u8840\u8102\u6307\u6807\u5747\u8fbe\u6807\uff08TC<4.5 mmol\/L\uff0c TG<1.5 mmol\/L\uff0c LDL\u2011C<2.6 mmol\/L\uff0cHDL\u2011C>1.04 mmol\/L\uff09\u7684\u60a3\u8005\u6bd4\u4f8b\u4ec5\u4e3a 12%\uff0c\u5176\u4e2dTC\u3001TG\u3001HDL\u2011C\u3001LDL\u2011C\u8fbe\u6807\u7387\u5206\u522b\u4e3a36.1%\u300146.6%\u300171.9%\u548c42.9%\uff3b16\uff3d<\/sup>\u3002\u53e6\u4e00\u9879\u9488\u5bf9\u5168\u56fd\u4e3b\u8981\u57ce\u5e02\u768420\u5bb6\u4e09\u7ea7\u533b\u9662\u5185\u5206\u6ccc\u79d1\u95e8\u8bca\u51714 807\u4f8b40~75\u5c81T2DM\u60a3\u8005\u7684\u6a2a\u65ad\u9762\u7814\u7a76\u663e\u793a\uff0c\u8840\u8102\u5f02\u5e38\u7684\u6bd4\u4f8b\u9ad8\u8fbe67.1%\uff1b\u5728\u8840\u8102\u5f02\u5e38\u7684T2DM\u60a3\u8005\u4e2d\uff0c\u77e5\u6653\u7387\u548c\u6cbb\u7597\u7387\u5206\u522b\u4e3a68.7% \u548c 55.9%\uff0cLDL\u2011C \u8fbe \u6807\uff08<2.6 mmol\/L\uff09\u7387 \u4e3a39.4%\uff0c\u975eHDL\u2011C\u8fbe\u6807\uff08<3.37 mmol\/L\uff09\u7387\u4e3a35.9%\uff3b17\uff3d<\/sup>\u3002<\/p>\n

\u6211\u56fd\u5f00\u5c55\u7684\u591a\u9879\u5168\u56fd\u6027\u591a\u4e2d\u5fc3\u7814\u7a76\u7ed3\u679c\u5927\u81f4\u53cd\u6620\u4e86\u5f53\u524dT2DM\u60a3\u8005\u4e2d\u8840\u8102\u5f02\u5e38\u7684\u60a3\u75c5\u53ca\u63a7\u5236\u60c5\u51b5\u4e0d\u5bb9\u4e50\u89c2\uff08\u9644\u88681\uff09\uff0c\u8be5\u7c7b\u60a3\u8005\u5e94\u7279\u522b\u6ce8\u610f\u8840\u8102\u7684\u603b\u4f53\u7ba1\u7406\uff0c\u53ca\u65e9\u5e72\u9884\u8840\u8102\u5f02\u5e38\u548c\u9884\u9632ASCVD\u3002<\/p>\n

\u9664\u4e86\u8840\u8102\u5f02\u5e38\u60a3\u75c5\u7387\u9ad8\u4e4b\u5916\uff0c\u6211\u56fdT2DM\u60a3\u8005\u7684\u8840\u8102\u5f02\u5e38\u8fd8\u8868\u73b0\u51fa\u5730\u57df\u5dee\u5f02\uff0c\u53ef\u80fd\u4e0e\u5404\u5730\u533a\u7ecf\u6d4e\u53d1\u5c55\u6c34\u5e73\u3001\u81ea\u7136\u6761\u4ef6\u548c\u5c45\u6c11\u751f\u6d3b\u4e60\u60ef\u4e0d\u540c\u6709\u5173\u3002\u897f\u5317\u5730\u533a\u7531\u4e8e\u7ecf\u6d4e\u6c34\u5e73\u548c\u533b\u7597\u6761\u4ef6\u76f8\u5bf9\u8f83\u5dee\uff0c\u60a3\u8005\u5bf9\u75be\u75c5\u7684\u81ea\u6211\u91cd\u89c6\u7a0b\u5ea6\u4f4e\uff0c\u52a0\u4e4b\u9ad8\u78b3\u6c34\u5316\u5408\u7269\u3001\u9ad8\u8102\u996e\u98df\u7b49\u56e0\u7d20\uff0cT2DM\u60a3\u8005\u4e2d\u8840\u8102\u5f02\u5e38\u7684\u60a3\u75c5\u7387\u9ad8\u4e8e\u5176\u4ed6\u5730\u533a\uff3b18\uff3d<\/sup> \u3002<\/p>\n

\u4e8c\u3001T1DM\u60a3\u8005<\/p>\n

\u5fc3\u8840\u7ba1\u75be\u75c5\u662fT1DM\u60a3\u8005\u6b7b\u4ea1\u7684\u4e3b\u8981\u539f\u56e0\u4e4b\u4e00\u3002\u4e00\u9879\u7eb3\u5165\u4e8626\u9879\u7814\u7a76\u7684Meta\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u975e\u7cd6\u5c3f\u75c5\u4eba\u7fa4\u76f8\u6bd4\uff0c\u7537\u6027T1DM\u60a3\u8005\u4e2d\u51a0\u5fc3\u75c5\u6807\u5316\u6b7b\u4ea1\u7387\u589e\u52a0\u4e865.62\u500d\uff0c\u5973\u6027T1DM\u60a3\u8005\u4e2d\u589e\u52a0\u4e8611.32\u500d\uff3b19\uff3d<\/sup> \u3002\u5c3d\u7ba1T1DM\u60a3\u8005\u7684ASCVD\u98ce\u9669\u589e\u52a0\uff0c\u4f46\u5173\u4e8e\u8be5\u4eba\u7fa4\u8840\u8102\u5f02\u5e38\u60a3\u75c5\u7387\u3001\u77e5\u6653\u7387\u548c\u6cbb\u7597\u7387\u7684\u5927\u89c4\u6a21\u7814\u7a76\u76f8\u5bf9\u8f83\u5c11\u3002\u4e00\u9879\u9488\u5bf9\u4e2d\u56fd24\u4e2a\u7701\u7ea7\u884c\u653f\u533a\u517118 976\u4f8b\u65b0\u8bca\u65ad\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u6a2a\u65ad\u9762\u8c03\u67e5\u5305\u542b\u4e86 1 158\u4f8b\u6210\u4ebaT1DM\u60a3\u8005\uff0c\u5176\u7ed3\u679c\u663e\u793a\uff0c\u65b0\u8bca\u65ad\u6210\u4ebaT1DM\u60a3\u8005\u4e2dTG>1.7 mmol\/L\u8005\u536029.0%\uff0cLDL\u2011C>2.6 mmol\/L\u8005\u536050.3%\uff0cHDL\u2011C \u5f02\u5e38\uff08\u7537\u6027<1.0 mmol\/L \u6216\u5973\u6027 <1.3 mmol\/L\uff09\u8005\u536039.6%\uff3b20\uff3d<\/sup>\uff08\u9644\u88681\uff09\u3002<\/p>\n

\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684ASCVD\u5371\u9669\u5206\u5c42\u4e0e\u6cbb\u7597\u76ee\u6807<\/p>\n

\u4e00\u3001\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u5fc3\u8840\u7ba1\u98ce\u9669\u8bc4\u4f30<\/p>\n

\u7531\u4e8e\u7cd6\u5c3f\u75c5\u662fASCVD\u7684\u91cd\u8981\u72ec\u7acb\u5371\u9669\u56e0\u7d20\uff0c\u8840\u8102\u5f02\u5e38\u5bf9\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684ASCVD\u98ce\u9669\u5f71\u54cd\u6700\u5927\uff0c\u56e0\u6b64\uff0c\u5176\u8840\u8102\u7ba1\u7406\u76ee\u6807\u503c\u8bbe\u5b9a\u8f83\u975e\u7cd6\u5c3f\u75c5\u4eba\u7fa4\u66f4\u4e3a\u4e25\u683c\u3002\u4e3a\u5f3a\u8c03\u7cd6\u5c3f\u75c5\u60a3\u8005\u964d\u8102\u8fbe\u6807\uff0c\u5efa\u8bae\u6839\u636e\u5176\u75c5\u7a0b\u957f\u77ed\u3001\u662f\u5426\u5408\u5e76ASCVD\u53ca\u4e3b\u8981\u9776\u5668\u5b98\u635f\u5bb3\u60c5\u51b5\uff0c\u5c06\u7cd6\u5c3f\u75c5\u60a3\u8005\u5206\u4e3a\u8d85\u9ad8\u5371\u3001\u6781\u9ad8\u5371\u548c\u9ad8\u5371\uff08\u88681\uff09\uff0c\u4ee5\u4fbf\u5bf9\u5176ASCVD\u98ce\u9669\u8fdb\u884c\u8bc4\u4f30\u3002<\/p>\n<\/p>\n

ASCVD\u5b9a\u4e49\uff1a\u6307\u8bca\u65ad\u660e\u786e\u7684\u51a0\u72b6\u52a8\u8109\u7ca5\u6837\u786c\u5316\u6027\u5fc3\u8840\u7ba1\u75be\u75c5\uff0c\u5305\u62ec\u65e2\u5f80\u8bca\u65ad\u6216\u73b0\u5728\u5b58\u5728\u6025\u6027\u51a0\u72b6\u52a8\u8109\u7efc\u5408\u5f81\uff08\u5fc3\u808c\u6897\u6b7b\u6216\u4e0d\u7a33\u5b9a\u6027\u5fc3\u7ede\u75db\uff09\u3001\u7a33\u5b9a\u6027\u5fc3\u7ede\u75db\u548c\u63a5\u53d7\u51a0\u72b6\u52a8\u8109\u8840\u8fd0\u91cd\u5efa\uff08\u7ecf\u76ae\u51a0\u72b6\u52a8\u8109\u6210\u5f62\u672f\/\u652f\u67b6\u7f6e\u5165\u672f\u6216\u51a0\u72b6\u52a8\u8109\u65c1\u8def\u79fb\u690d\u672f\uff09\uff1b\u8bca\u65ad\u660e\u786e\u7684\u8111\u5352\u4e2d\u548c\u77ed\u6682\u6027\u8111\u7f3a\u8840\u53d1\u4f5c\uff1b\u8bca\u65ad\u660e\u786e\u7684\u5916\u5468\u52a8\u8109\u75be\u75c5<\/p>\n

a <\/sup>\u5371\u9669\u56e0\u7d20\u5305\u62ec\uff1a\uff081\uff09\u5438\u70df\uff1b\uff082\uff09\u9ad8\u8840\u538b\uff1b\uff083\uff09\u80a5\u80d6\uff1a\u4f53\u91cd\u6307\u6570\u226528 kg\/m 2<\/sup> \uff1b\uff084\uff09\u65e9\u53d1\u51a0\u5fc3\u75c5\u5bb6\u65cf\u53f2\uff08\u7537\u6027<55\u5c81\uff0c\u5973\u6027<65\u5c81\uff09\uff1b\uff085\uff09\u975e\u9ad8\u5bc6\u5ea6\u8102\u86cb\u767d\u80c6\u56fa\u9187\u22654.9 mmol\/L\uff1b\uff086\uff09\u8102\u86cb\u767d\uff08a\uff09\u2265300 mg\/L\uff3b22\u201123\uff3d<\/sup> \uff1b\uff087\uff09\u9ad8\u654fC\u53cd\u5e94\u86cb\u767d\u22652.0 mg\/L\uff3b24\u201125\uff3d \u3002\u5371\u9669\u56e0\u7d20\u5747\u4e3a\u5e72\u9884\u524d\u6c34\u5e73<\/p>\n

b<\/sup> \u9776\u5668\u5b98\u635f\u5bb3\u5305\u62ec\uff1a\u6162\u6027\u80be\u810f\u75c53b\u671f\u4ee5\u4e0a\uff3b\u4f30\u7b97\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387<45 ml\u00b7min -1<\/sup> \u00b7\uff081.73 m 2<\/sup> \uff09-1 <\/sup>\uff3d\uff0c\u86cb\u767d\u5c3f\uff08\u5c3f\u767d\u86cb\u767d\/\u808c\u9150\u6bd4\u503c>300 mg\/g\uff09\uff0c\u8e1d\u80b1\u6bd4\u503c<0.9\uff0c\u5de6\u5fc3\u5ba4\u6536\u7f29\/\u8212\u5f20\u529f\u80fd\u969c\u788d<\/p>\n

\u4e8c\u3001\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u8840\u8102\u5e72\u9884\u9776\u70b9\u53ca\u76ee\u6807\u503c<\/p>\n

\uff08\u4e00\uff09\u8840\u8102\u5e72\u9884\u9776\u70b9<\/p>\n

\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u8840\u8102\u5e72\u9884\u9776\u70b9\u53ca\u76ee\u6807\u503c\u89c1\u88682\u3002<\/p>\n<\/p>\n

1.LDL\u2011C\uff1a\u591a\u6570\u964d\u8102\u5e72\u9884\u7814\u7a76\u5747\u91c7\u7528LDL\u2011C\u4f5c\u4e3a\u89c2\u5bdf\u964d\u8102\u6548\u679c\u4e0eASCVD\u98ce\u9669\u4e0b\u964d\u5173\u7cfb\u7684\u6307\u6807\u3002\u80c6\u56fa\u9187\u6cbb\u7597\u8bd5\u9a8c\u534f\u4f5c\u7ec4\u7684\u4e00\u9879Meta\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0cLDL\u2011C\u6bcf\u964d\u4f4e1.0 mmol\/L\u53ef\u4f7f\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684MACE\u3001\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u548c\u7f3a\u8840\u6027\u8111\u5352\u4e2d\u98ce\u9669\u5206\u522b\u4e0b\u964d21%\u300113%\u548c21%\uff0c\u4e14\u4e0e\u57fa\u7ebfLDL\u2011C\u6c34\u5e73\u65e0\u5173\uff3b29\uff3d<\/sup>\u3002\u591a\u9879\u4e34\u5e8a\u7814\u7a76\u663e\u793a\uff0c40~75\u5c81\u7684T2DM\u60a3\u8005\u53ef\u4ee5\u4ece\u670d\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u4e2d\u83b7\u76ca\u3002\u5728\u4e00\u7ea7\u9884\u9632\u7814\u7a76\u4e2d\uff0c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u4f7fLDL\u2011C\u964d\u81f32.6 mmol\/L\u4ee5\u4e0b\u53ef\u663e\u8457\u964d\u4f4eASCVD\u6216\u5168\u56e0\u6b7b\u4ea1\u98ce\u9669\uff3b30\u201131\uff3d<\/sup> \u3002T2DM\u60a3\u8005\u5982\u5177\u6709\u591a\u9879ASCVD\u5371\u9669\u56e0\u7d20\u6216\u9776\u5668\u5b98\u635f\u5bb3\uff0c\u76f8\u5f53\u4e8e\u5177\u6709ASCVD\uff0c\u5efa\u8bae\u5bf9\u4e8e\u8fd9\u90e8\u5206\u7cd6\u5c3f\u75c5\u60a3\u8005\uff0c\u5e94\u4f7fLDL\u2011C\u8f83\u57fa\u7ebf\u964d\u4f4e >50%\uff0c\u5e76\u5c06 LDL\u2011C \u76ee\u6807\u503c\u5b9a\u4e3a<1.8 mmol\/L\uff3b32\u201134\uff3d<\/sup> \u3002\u5728\u4e8c\u7ea7\u9884\u9632\u7814\u7a76\u4e2d\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u8054\u5408\u4f9d\u6298\u9ea6\u5e03\u6216\u524d\u86cb\u767d\u8f6c\u5316\u9176\u67af\u8349\u6eb6\u83cc\u7d209 \uff08proprotein convertase subtilisin\/kexin type 9\uff0cPCSK9\uff09\u6291\u5236\u5242\u7684\u591a\u9879\u5f3a\u5316\u964d\u8102\u7814\u7a76\u7684\u5206\u5c42\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0cLDL\u2011C\u5982\u964d\u81f31.4 mmol\/L\u4ee5\u4e0b\uff0cT2DM\u60a3\u8005\u7684ASCVD\u98ce\u9669\u53ef\u8fdb\u4e00\u6b65\u4e0b\u964d\uff0c\u4e14\u5408\u5e76T2DM\u7684ASCVD\u60a3\u8005\u53ef\u4ece\u5f3a\u5316\u964d\u8102\u6cbb\u7597\u4e2d\u83b7\u76ca\u66f4\u591a\uff3b26\u201128\uff3d<\/sup> \u3002<\/p>\n

\u76ee\u524d\u7f3a\u4e4f\u9488\u5bf9 T1DM \u60a3\u8005\u7684\u964d\u8102\u5e72\u9884\u7814\u7a76\u3002\u5728\u5fc3\u810f\u4fdd\u62a4\u7814\u7a76\uff08HPS\uff09\u4e2d\uff0c40\u5c81\u4ee5\u4e0a\u7684T1DM\u60a3\u8005\u63a5\u53d7\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\u7684\u83b7\u76ca\u4e0eT2DM\u60a3\u8005\u7c7b\u4f3c\uff3b30\uff3d<\/sup> \uff0c\u4f9d\u6b64\u63a8\u8350\u5176\u964d\u8102\u9776\u70b9\u4e0e\u76ee\u6807\u503c\u540cT2DM\u60a3\u8005\u3002<\/p>\n

\u572840\u5c81\u4ee5\u4e0bT2DM\u548cT1DM\u60a3\u8005\u4e2d\uff0c\u964d\u8102\u6cbb\u7597\u7684\u5fc3\u8840\u7ba1\u83b7\u76ca\u5c1a\u7f3a\u4e4f\u4e34\u5e8a\u7814\u7a76\u8bc1\u636e\u3002\u8003\u8651\u523040\u5c81\u4ee5\u4e0b\u7cd6\u5c3f\u75c5\u60a3\u8005\u867d\u713610\u5e74\u5fc3\u8840\u7ba1\u98ce\u9669\u4f4e\uff0c\u4f46\u4f59\u751f\u98ce\u9669\u589e\u52a0\uff0c\u56e0\u6b6440\u5c81\u4ee5\u4e0b\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684LDL\u2011C\u4e5f\u5e94\u63a7\u5236\u5728\u8f83\u4f4e\u6c34\u5e73\u3002\u6b64\u65f6\uff0c\u5e94\u7efc\u5408\u8003\u8651\u7cd6\u5c3f\u75c5\u75c5\u7a0b\u53ca\u5176\u4ed6\u5fc3\u8840\u7ba1\u5371\u9669\u56e0\u7d20\u548c\u9776\u5668\u5b98\u635f\u5bb3\u60c5\u51b5\uff0c\u5728\u5145\u5206\u8ba8\u8bba\u6cbb\u7597\u98ce\u9669\u4e0e\u83b7\u76ca\u7684\u57fa\u7840\u4e0a\uff0c\u9002\u65f6\u542f\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\uff3b35\u201136\uff3d<\/sup>\u3002<\/p>\n

2.\u975eHDL\u2011C\uff1a\u4ec5\u91c7\u7528LDL\u2011C\u4f5c\u4e3a\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u964d\u8102\u76ee\u6807\u53ef\u80fd\u4f1a\u4f4e\u4f30ASCVD\u98ce\u9669\uff0c\u975eHDL\u2011C\u4e5f\u662f\u7cd6\u5c3f\u75c5\u60a3\u8005\u9700\u8981\u7ba1\u7406\u7684\u9996\u8981\u964d\u8102\u9776\u70b9\u3002\u975eHDL\u2011C\u662f\u8840\u6d46\u4e2d\u7684TC\u51cf\u53bbHDL\u4e2d\u7684\u80c6\u56fa\u9187\uff0c\u4ee3\u8868\u4e86\u5168\u90e8\u81f4\u52a8\u8109\u7ca5\u6837\u786c\u5316\u8102\u86cb\u767d\u9897\u7c92\u4e2d\u7684\u80c6\u56fa\u9187\u3002\u65e0\u8bba\u662f\u5426\u63a5\u53d7\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\uff0c\u975e HDL\u2011C \u8f83 LDL\u2011C \u80fd\u66f4\u597d\u5730\u53cd\u6620 ASCVD \u98ce\u9669\uff3b14\uff0c 37\u201138\uff3d<\/sup> \u3002Meta \u5206\u6790\u53d1\u73b0\uff0c\u975eHDL\u2011C\u964d\u4f4e\u5e45\u5ea6\u4e0eASCVD\u98ce\u9669\u964d\u4f4e\u5e45\u5ea6\u7684\u76f8\u5173\u6027\u5f3a\u4e8eLDL\u2011C\u964d\u4f4e\u5e45\u5ea6\u4e0eASCVD\u98ce\u9669\u964d\u4f4e\u5e45\u5ea6\u7684\u76f8\u5173\u6027\uff3b39\uff3d<\/sup> \u3002\u6b64\u5916\uff0c\u76ee\u524d\u591a\u91c7\u7528 Friedewald \u516c\u5f0f\u8ba1\u7b97LDL\u2011C \u6c34\u5e73\uff0c\u5f53\u8840\u6d46 TG>4.5 mmol\/L \u6216 LDL\u2011C<1.8 mmol\/L\u65f6\uff0c\u6b64\u65b9\u6cd5\u9762\u4e34\u4e00\u5b9a\u7684\u6311\u6218\uff3b40\u201141\uff3d <\/sup>\u3002\u7531\u4e8e\u7cd6\u5c3f\u75c5\u60a3\u8005\u8840\u8102\u5f02\u5e38\u4ee5\u9ad8TG\u8840\u75c7\u4e3a\u7279\u5f81\uff0c\u5355\u7eaf\u4ee5LDL\u2011C \u4f5c\u4e3a\u9996\u8981\u76ee\u6807\u5177\u6709\u4e00\u5b9a\u7684\u5c40\u9650\u6027\uff0c\u800c\u975eHDL\u2011C\u8ba1\u7b97\u7b80\u5355\uff0c\u7ed3\u679c\u8f83\u7a33\u5b9a\uff0c\u4e14\u53d7\u8840\u6d46TG\u6c34\u5e73\u5f71\u54cd\u5c0f\uff0c\u56e0\u6b64\uff0c\u975eHDL\u2011C\u9002\u5408\u4e0eLDL\u2011C\u4e00\u8d77\u4f5c\u4e3a\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u9996\u8981\u964d\u8102\u9776\u70b9\u3002<\/p>\n

3. \u8f7d\u8102\u86cb\u767dB\uff08apolipoprotein B\uff0cApoB\uff09\uff1a\u65e0\u8bba\u9897\u7c92\u5927\u5c0f\uff0c\u6240\u6709\u81f4\u52a8\u8109\u7ca5\u6837\u786c\u5316\u8102\u86cb\u767d\u9897\u7c92\u5747\u542b1\u4e2a\u5206\u5b50ApoB\u3002\u4ece\u7406\u8bba\u4e0a\u800c\u8a00\uff0cApoB\u68c0\u6d4b\u80fd\u66f4\u51c6\u786e\u5730\u53cd\u6620\u81f4\u52a8\u8109\u7ca5\u6837\u786c\u5316\u8102\u86cb\u767d\u9897\u7c92\u6570\u91cf\u3002\u7cd6\u5c3f\u75c5\u6613\u5408\u5e76\u9ad8TG\u8840\u75c7\uff0c\u6b64\u65f6ApoB\u542b\u91cf\u9ad8\u800cLDL\u2011C\u6c34\u5e73\u4e0d\u9ad8\u3002\u56e0\u6b64\uff0c\u540c\u65f6\u6d4b\u5b9aApoB\u4e0eLDL\u2011C\u6c34\u5e73\u6709\u5229\u4e8e\u5224\u65ad\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684ASCVD\u98ce\u9669\uff3b14\uff0c 39\uff3d <\/sup>\u3002\u8fd1\u671f\u7684\u5f3a\u5316\u964d\u8102\u7814\u7a76\u63d0\u793a\uff0c\u5728\u63a7\u5236LDL\u2011C\u548c\u975eHDL\u2011C\u7684\u4f5c\u7528\u540e\uff0cApoB\u964d\u4f4e\u5e45\u5ea6\u80fd\u72ec\u7acb\u9884\u6d4bASCVD\u98ce\u9669\u7684\u4e0b\u964d\uff3b42\uff3d<\/sup> \u3002\u9274\u4e8e\u76ee\u524dApoB\u68c0\u6d4b\u6210\u672c\u8f83\u9ad8\u3001\u5c1a\u672a\u5728\u4e34\u5e8a\u5e7f\u6cdb\u5e94\u7528\uff0c\u5176\u53ef\u4f5c\u4e3a\u7cd6\u5c3f\u75c5\u60a3\u8005ASCVD\u98ce\u9669\u5e72\u9884\u7684\u6b21\u8981\u9776\u70b9\u3002<\/p>\n

\uff08\u4e8c\uff09\u6f5c\u5728\u8c03\u8102\u9776\u70b9<\/p>\n

TG\u3001\u8102\u86cb\u767d\uff08a\uff09\uff3blipoprotein\uff08a\uff09\uff0cLp\uff08a\uff09\uff3d\u53caHDL\u2011C\u5f02\u5e38\u5747\u4e0eASCVD\u98ce\u9669\u589e\u52a0\u6709\u5173\uff0c\u4f46\u662f\u76ee\u524d\u7f3a\u4e4f\u8f83\u5f3a\u8bc1\u636e\u652f\u6301\u836f\u7269\u5e72\u9884\u8fd9\u4e9b\u8840\u8102\u6307\u6807\u80fd\u964d\u4f4eASCVD\u98ce\u9669\uff0c\u56e0\u6b64\u5c06\u5176\u5217\u4e3a\u7cd6\u5c3f\u75c5\u60a3\u8005ASCVD\u98ce\u9669\u7ba1\u63a7\u7684\u6f5c\u5728\u8c03\u8102\u9776\u70b9\uff0c\u4e34\u5e8a\u4e5f\u9700\u4e88\u4ee5\u5173\u6ce8\u3002<\/p>\n

1. TG\uff1a\u9ad8TG\u8840\u75c7\u5728\u7cd6\u5c3f\u75c5\u60a3\u8005\u4e2d\u5f88\u5e38\u89c1\uff0c\u8840\u6d46TG\u7edd\u5927\u90e8\u5206\u4f4d\u4e8eTRL\u4e2d\uff0c\u6b64\u65f6\u60a3\u8005\u8868\u73b0\u4e3a\u6b8b\u7c92\u80c6\u56fa\u9187\u548c\u975eHDL\u2011C\u6c34\u5e73\u5347\u9ad8\uff0c\u8fd9\u4e5f\u662fTG\u6c34\u5e73\u8f7b\u5ea6\u81f3\u4e2d\u5ea6\u5347\u9ad8\u589e\u52a0ASCVD\u98ce\u9669\u7684\u539f\u56e0\u6240\u5728\u3002TG\u6c34\u5e73\u5347\u9ad8\u548cTRL\u4e2d\u7684\u6b8b\u7c92\u80c6\u56fa\u9187\u589e\u52a0\u662f\u5fc3\u808c\u6897\u6b7b\u7684\u5371\u9669\u56e0\u7d20\uff3b43\uff3d<\/sup> \u3002\u901a\u8fc7\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u53ca\u4f18\u5316\u964d\u7cd6\u836f\u7269\u53ef\u964d\u4f4e\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684TG\u6c34\u5e73\u53caASCVD\u98ce\u9669\uff3b44\u201147\uff3d<\/sup> \uff0c\u4f46\u662f\u4ee5TG\u4e3a\u9776\u70b9\u7684\u964d\u8102\u836f\u7269\uff08\u8d1d\u7279\u7c7b\u836f\u7269\u3001\u5904\u65b9\u7ea7\u9c7c\u6cb9\u5236\u5242\u3001\u70df\u9178\u7c7b\u836f\u7269\u7b49\uff09\u6cbb\u7597\u80fd\u5426\u964d\u4f4eASCVD\u9ad8\u98ce\u9669\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684MACE\u53d1\u751f\u98ce\u9669\u5c1a\u5b58\u4e89\u8bae\uff3b48\u201153\uff3d<\/sup>\u3002\u56e0\u6b64\uff0c\u76ee\u524d\u4ec5\u5c06TG\u4f5c\u4e3a\u7cd6\u5c3f\u75c5\u60a3\u8005ASCVD\u98ce\u9669\u7ba1\u63a7\u7684\u6f5c\u5728\u6307\u6807\u3002<\/p>\n

2. Lp\uff08a\uff09\uff1a\u5728 T2DM\u60a3\u8005\u4e2d\uff0cLp\uff08a\uff09\u6c34\u5e73\u5347\u9ad8\u662f\u51a0\u5fc3\u75c5\u548c\u7f3a\u8840\u6027\u8111\u5352\u4e2d\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\uff3b32\uff0c 54\u201156\uff3d<\/sup> \u3002\u5bf9\u4e8e\u7cd6\u5c3f\u75c5\u5408\u5e76\u7a33\u5b9a\u6027\u5fc3\u7ede\u75db\u7684\u60a3\u8005\uff0cLp\uff08a\uff09\u6c34\u5e73\u5347\u9ad8\u663e\u8457\u589e\u52a0MACE\u53d1\u751f\u98ce\u9669\uff3b57\uff3d<\/sup> \u3002<\/p>\n

\u63a8\u8350\u6210\u4eba\u4e00\u751f\u4e2d\u81f3\u5c11\u5e94\u68c0\u6d4b\u4e00\u6b21Lp\uff08a\uff09\uff3b32\uff0c 54\u201156\uff3d<\/sup> \u3002\u57fa\u4e8e\u6211\u56fd\u4eba\u7fa4\u7684\u7814\u7a76\u6570\u636e\uff3b57\u201162\uff3d<\/sup> \uff0c\u5efa\u8bae\u5c06 Lp\uff08a\uff09>300 mg\/L\u4f5c\u4e3a\u589e\u52a0ASCVD\u98ce\u9669\u7684\u5207\u70b9\u503c\uff3b63\uff3d<\/sup> \u3002<\/p>\n

3.HDL\u2011C\uff1a\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u8840\u8102\u7279\u70b9\u4e4b\u4e00\u662fHDL\u2011C\u6c34\u5e73\u964d\u4f4e\uff0c\u5c3d\u7ba1\u4f4e\u6c34\u5e73\u7684 HDL\u2011C\u662f ASCVD\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\uff0c\u4f46\u662f HDL\u2011C\u5bf9\u51a0\u5fc3\u75c5\u7684\u9884\u6d4b\u4f5c\u7528\u53d7HDL\u529f\u80fd\u7684\u5f71\u54cd\uff0cHDL\u529f\u80fd\u8f83HDL\u2011C\u6c34\u5e73\u80fd\u66f4\u597d\u5730\u9884\u6d4bASCVD\u98ce\u9669\u3002\u6b64\u5916\uff0c\u9057\u4f20\u5b66\u8bc1\u636e\u672a\u80fd\u8bc1\u660eHDL\u2011C\u6c34\u5e73\u4e0eASCVD\u98ce\u9669\u7684\u5173\u7cfb\uff0c\u901a\u8fc7\u836f\u7269\u5347\u9ad8HDL\u2011C\u6c34\u5e73\u7684\u6cbb\u7597\u5e76\u672a\u80fd\u5e26\u6765\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u98ce\u9669\u7684\u4e0b\u964d\u3002\u56e0\u6b64\uff0cHDL\u2011C\u5e76\u672a\u88ab\u7eb3\u5165ASCVD\u98ce\u9669\u7ba1\u7406\u7684\u8840\u8102\u5e72\u9884\u76ee\u6807\uff0c\u53ea\u4f5c\u4e3a\u7ba1\u7406\u6307\u6807\uff3b32\uff0c 64\uff3d<\/sup> \u3002<\/p>\n

\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u964d\u8102\u6cbb\u7597\u7b56\u7565<\/p>\n

\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u964d\u8102\u8fbe\u6807\u7b56\u7565\u5305\u62ec\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u548c\u836f\u7269\u6cbb\u7597\uff0c\u5177\u4f53\u63a8\u8350\u5efa\u8bae\u89c1\u88683\u3002<\/p>\n<\/p>\n

\u4e00\u3001\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884<\/p>\n

\u5bf9\u4e8e\u7cd6\u5c3f\u75c5\uff08\u5305\u62ecT1DM\u548cT2DM\uff09\u60a3\u8005\uff0c\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u662f\u8840\u8102\u7ba1\u7406\u7684\u57fa\u7840\uff0c\u4e0d\u4ec5\u6709\u52a9\u4e8e\u964d\u4f4e\u5176\u8840\u8102\u6c34\u5e73\uff0c\u8fd8\u53ef\u5bf9\u5176\u8840\u538b\u3001\u8840\u7cd6\u4ee5\u53ca\u6574\u4f53\u5fc3\u8840\u7ba1\u5065\u5eb7\u72b6\u51b5\u4ea7\u751f\u6709\u76ca\u7684\u5f71\u54cd\u3002\u5065\u5eb7\u3001\u89c4\u8303\u7684\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u5305\u62ec\u4ee5\u4e0b\u5185\u5bb9\u3002<\/p>\n

1.\u5065\u5eb7\u5747\u8861\u7684\u81b3\u98df\uff3b36\uff0c 73\uff0c 86\uff3d<\/sup> \uff1a\u9650\u5236\u603b\u8102\u80aa\u3001\u9971\u548c\u8102\u80aa\u9178\u3001\u80c6\u56fa\u9187\u548c\u53cd\u5f0f\u8102\u80aa\u9178\u7684\u6444\u5165\uff0c\u662f\u9632\u6cbb\u9ad8\u8102\u8840\u75c7\u548cASCVD\u7684\u91cd\u8981\u63aa\u65bd\u3002\u81b3\u98df\u8102\u80aa\u7684\u6444\u5165\u91cf\u5e94\u4e0d\u8d85\u8fc7\u6bcf\u65e5\u603b\u70ed\u91cf\u768420%~30%\u3002\u9971\u548c\u8102\u80aa\u9178\u6444\u5165\u91cf\u4e0d\u8d85\u8fc7\u6bcf\u65e5\u603b\u70ed\u91cf\u768410%\uff0c\u9ad8\u80c6\u56fa\u9187\u8840\u75c7\u8005\u5e94\u964d\u4f4e\u9971\u548c\u8102\u80aa\u9178\u6444\u5165\u91cf\uff0c\u4f7f\u5176\u4f4e\u4e8e\u6bcf\u65e5\u603b\u70ed\u91cf\u76847%\uff0c\u5c11\u5403\u5bcc\u542b\u80c6\u56fa\u9187\u7684\u98df\u7269\uff08\u5982\u52a8\u7269\u5185\u810f\u7b49\uff09\uff0c\u6bcf\u65e5\u80c6\u56fa\u9187\u6444\u5165\u91cf\u5e94<300 mg\u3002\u53cd\u5f0f\u8102\u80aa\u9178\uff08\u5982\u6c22\u5316\u690d\u7269\u6cb9\u7b49\uff09\u6444\u5165\u91cf\u5e94\u4f4e\u4e8e\u6bcf\u65e5\u603b\u70ed\u91cf\u7684 1%\uff0c\u5373\u4e0d\u5b9c\u8d85\u8fc72 g\/d\u3002\u9002\u5f53\u589e\u52a0\u4e0d\u9971\u548c\u8102\u80aa\u9178\uff08\u690d\u7269\u6cb9\uff09\u7684\u6444\u5165\uff0c\u7279\u522b\u662f\u5bcc\u542b\u03c9\u20113\u591a\u4e0d\u9971\u548c\u8102\u80aa\u9178\u7684\u98df\u7269\uff3b87\uff3d<\/sup> \u3002<\/p>\n

\u53ef\u91c7\u7528\u5730\u4e2d\u6d77\u996e\u98df\uff3b88\uff3d<\/sup> \u6216\u7ec8\u6b62\u9ad8\u8840\u538b\u81b3\u98df\u7597\u6cd5\uff08dietary approaches to stop hypertension\uff0cDASH\uff09\u996e\u98df\u7b49\u996e\u98df\u6a21\u5f0f\uff0c\u589e\u52a0\u852c\u83dc\u3001\u6c34\u679c\u3001\u7c97\u7ea4\u7ef4\u98df\u7269\u3001\u5bcc\u542b\u03c9\u20113\u8102\u80aa\u9178\u9c7c\u7c7b\u7684\u6444\u5165\uff0c\u81b3\u98df\u7ea4\u7ef4\u6444\u5165\u91cf\u5e94\u4e0d\u5c11\u4e8e25~30 g\/d\u621614 g\/1 000 kcal\uff0c\u5efa\u8bae\u8fbe\u523035 g\/d\u3002\u78b3\u6c34\u5316\u5408\u7269\u3001\u86cb\u767d\u8d28\u4f9b\u80fd\u5360\u6bd4\u540c\u666e\u901a\u7cd6\u5c3f\u75c5\u60a3\u8005\u3002\u9ad8TG\u8840\u75c7\u60a3\u8005\u996e\u98df\u6210\u5206\u4e2d\u9664\u9650\u5236\u8102\u80aa\u9178\u7684\u6444\u5165\u5916\uff0c\u5e94\u5c24\u5176\u6ce8\u610f\u51cf\u5c11\u7cbe\u5236\u78b3\u6c34\u5316\u5408\u7269\u6444\u5165\uff0c\u589e\u52a0\u7ea4\u7ef4\u542b\u91cf\u4e30\u5bcc\u7684\u4f4e\u7cd6\u996e\u98df\uff08\u5982\u5168\u8c37\u7c7b\u7684\u7c97\u7cae\uff09\u6444\u5165\u3002<\/p>\n

2.\u9002\u5ea6\u7684\u8fd0\u52a8\uff1a\u6bcf\u5468\u5e94\u8fdb\u884c150 min\u4ee5\u4e0a\u7684\u4e2d\u7b49\u5f3a\u5ea6\u8fd0\u52a8\uff0c\u53ef\u4e2a\u4f53\u5316\u5236\u5b9a\u8fd0\u52a8\u5904\u65b9\u3002\u9700\u51cf\u91cd\u8005\u8fd8\u5e94\u7ee7\u7eed\u589e\u52a0\u6bcf\u5468\u8fd0\u52a8\u5f3a\u5ea6\u548c\u65f6\u95f4\u3002\u5728\u7a7a\u8179\u8840\u7cd6>16.7 mmo\/L\u3001\u53cd\u590d\u4f4e\u8840\u7cd6\u53d1\u4f5c\u6216\u8840\u7cd6\u6ce2\u52a8\u8f83\u5927\u3001\u6709DKA\u7b49\u6025\u6027\u5e76\u53d1\u75c7\u4ee5\u53ca\u5408\u5e76\u6025\u6027\u611f\u67d3\u3001\u589e\u6b96\u671f\u89c6\u7f51\u819c\u75c5\u53d8\u3001\u4e25\u91cd\u80be\u75c5\u548c\u4e25\u91cd\u5fc3\u8111\u8840\u7ba1\u75be\u75c5\uff08\u4e0d\u7a33\u5b9a\u6027\u5fc3\u7ede\u75db\u3001\u4e25\u91cd\u5fc3\u5f8b\u5931\u5e38\u3001\u77ed\u6682\u6027\u8111\u7f3a\u8840\u53d1\u4f5c\uff09\u7b49\u60c5\u51b5\u4e0b\u4e0d\u9002\u5b9c\u8fd0\u52a8\uff0c\u5f85\u75c5\u60c5\u7a33\u5b9a\u540e\u65b9\u53ef\u9010\u6b65\u6062\u590d\u8fd0\u52a8\uff3b73\uff3d<\/sup> \u3002<\/p>\n

3.\u7ef4\u6301\u7406\u60f3\u7684\u4f53\u91cd\uff1a\u5efa\u8bae\u901a\u8fc7\u63a7\u5236\u603b\u70ed\u91cf\u6444\u5165\u4ee5\u53ca\u589e\u52a0\u8fd0\u52a8\u91cf\uff0c\u5c06\u4f53\u91cd\u6307\u6570\u7ef4\u6301\u5728<24 kg\/m 2<\/sup> \u3002\u8d85\u91cd\u6216\u80a5\u80d6\u8005\u51cf\u91cd\u7684\u521d\u6b65\u76ee\u6807\u4e3a3~6\u4e2a\u6708\u51cf\u8f7b\u4f53\u91cd\u76845%~10%\u3002\u6d88\u7626\u8005\u5e94\u901a\u8fc7\u5408\u7406\u7684\u8425\u517b\u8ba1\u5212\u6062\u590d\u5e76\u957f\u671f\u7ef4\u6301\u7406\u60f3\u4f53\u91cd\uff3b73\uff3d<\/sup> \u3002<\/p>\n

4.\u63a7\u5236\u5176\u4ed6\u5371\u9669\u56e0\u7d20\uff1a\u6212\u70df\uff08\u5305\u62ec\u7535\u5b50\u70df\uff09\uff1b\u65e0\u996e\u9152\u4e60\u60ef\u8005\u4e0d\u5efa\u8bae\u996e\u9152\uff0c\u6709\u996e\u9152\u4e60\u60ef\u8005\u9650\u5236\u996e\u9152\uff0c\u9152\u7cbe\u6444\u5165\u91cf\u7537\u6027<25 g\/d\uff0c\u5973\u6027<15 g\/d\u3002\u996e\u9152\u662fTG\u5347\u9ad8\u7684\u91cd\u8981\u5f71\u54cd\u56e0\u7d20\uff0c\u9ad8TG\u8840\u75c7\u8005\u66f4\u9700\u4e25\u683c\u9650\u5236\u9152\u7cbe\u6444\u5165\u3002<\/p>\n

\u603b\u4e4b\uff0c\u65e0\u8bba\u5408\u5e76\u54ea\u79cd\u7c7b\u578b\u7684\u8840\u8102\u5f02\u5e38\uff0c\u5065\u5eb7\u5747\u8861\u7684\u81b3\u98df\u5747\u9700\u8d2f\u7a7f\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u59cb\u7ec8\u3002\u63a7\u5236TC\u548cLDL\u2011C\uff0c\u9700\u5728\u5408\u7406\u81b3\u98df\u57fa\u7840\u4e0a\uff0c\u89c4\u5f8b\u8fd0\u52a8\u548c\u63a7\u5236\u4f53\u91cd\uff1b\u5347\u9ad8HDL\u2011C\u5e94\u91cd\u89c6\u6212\u70df\uff1b\u964d\u4f4eTG\u5219\u9700\u9650\u9152\u3001\u89c4\u5f8b\u8fd0\u52a8\u548c\u63a7\u5236\u4f53\u91cd\uff3b68\uff3d<\/sup> \u3002<\/p>\n

\u4e8c\u3001\u964d\u80c6\u56fa\u9187\u836f\u7269\u6cbb\u7597\u7b56\u7565<\/p>\n

\u5bf9\u4e8e\u6240\u6709\u6210\u4eba\u7cd6\u5c3f\u75c5\u60a3\u8005\uff0c\u5c3d\u7ba1\u5065\u5eb7\u7684\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u4e3a\u964d\u8102\u6cbb\u7597\u7684\u57fa\u7840\uff0c\u4f46\u4ec5\u901a\u8fc7\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u5f80\u5f80\u96be\u4ee5\u964d\u8102\u8fbe\u6807\uff0c\u5efa\u8bae\u5728\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u7684\u540c\u65f6\u542f\u52a8\u836f\u7269\u6cbb\u7597\uff0c\u4ee5\u5c3d\u65e9\u4f7f\u964d\u8102\u9776\u70b9\u8fbe\u6807\uff0c\u51cf\u5c11ASCVD\u4e8b\u4ef6\u3002\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u964d\u80c6\u56fa\u9187\u6cbb\u7597\u7b56\u7565\u548c\u6d41\u7a0b\u89c1\u56fe1\u3002<\/p>\n<\/p>\n

\u56fe1 \u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u964d\u80c6\u56fa\u9187\u6cbb\u7597\u7b56\u7565\u548c\u6d41\u7a0b<\/p>\n

\u964d\u80c6\u56fa\u9187\u836f\u7269\u6839\u636e\u673a\u5236\u53ef\u5206\u4e3a\u4e09\u5927\u7c7b\uff0c\u5305\u62ec\u4ed6\u6c40\u7c7b\u836f\u7269\u3001\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u548cPCSK9\u6291\u5236\u5242\u3002\u6b64\u5916\uff0c\u4e34\u5e8a\u4e0a\u5c1a\u6709\u5176\u4ed6\u964d\u80c6\u56fa\u9187\u836f\u7269\uff0c\u5982\u8840\u8102\u5eb7\u3001\u80c6\u6c41\u9178\u87af\u5408\u5242\u3001\u666e\u7f57\u5e03\u8003\u3001\u8102\u5fc5\u6cf0\u3001\u591a\u5eff\u70f7\u9187\u7b49\u3002\u672c\u5171\u8bc6\u7740\u91cd\u4ecb\u7ecd\u76ee\u524d\u5728\u4e34\u5e8a\u4e0a\u5e38\u7528\u7684\u524d\u4e09\u5927\u7c7b\u964d\u80c6\u56fa\u9187\u836f\u7269\uff08\u88684\uff09\u3002<\/p>\n<\/p>\n

1.\u4ed6\u6c40\u7c7b\u836f\u7269\uff1a\u4e3a\u964d\u80c6\u56fa\u9187\u6cbb\u7597\u7684\u57fa\u7840\u836f\u7269\uff0c\u901a\u8fc7\u6291\u5236\u80c6\u56fa\u9187\u5408\u6210\u9650\u901f\u91763\u7f9f\u57fa3\u7532\u57fa\u620a\u4e8c\u9170\u8f85\u9176A\u8fd8\u539f\u9176\uff0c\u51cf\u5c11\u80c6\u56fa\u9187\u5408\u6210\uff0c\u4ece\u800c\u53cd\u9988\u4e0a\u8c03\u809d\u7ec6\u80de\u8868\u9762\u7684 LDL\u53d7\u4f53\uff0c\u4fc3\u8fdb\u809d\u7ec6\u80de\u6444\u53d6\u5e76\u6e05\u9664\u8840\u6db2\u4e2d\u7684LDL\u9897\u7c92\uff0c\u663e\u8457\u964d\u4f4e\u8840\u6e05TC\u3001LDL\u2011C\u548cApoB\u6c34\u5e73\u3002\u591a\u9879\u7814\u7a76\u7ed3\u679c\u8bc1\u5b9e\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u53ef\u663e\u8457\u51cf\u5c11\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684ASCVD\u4e8b\u4ef6\uff08\u9644\u88682\uff09\uff0c\u4e14\u4e34\u5e8a\u83b7\u76ca\u5927\u5c0f\u4e0e\u5176\u5bf9LDL\u2011C\u7684\u964d\u4f4e\u5e45\u5ea6\u5448\u7ebf\u6027\u6b63\u76f8\u5173\u3002\u7136\u800c\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u5242\u91cf\u589e\u500d\u65f6\uff0cLDL\u2011C\u964d\u4f4e\u5e45\u5ea6\u4ec5\u589e\u52a06%\uff0c\u5e76\u6709\u6f5c\u5728\u4e0d\u826f\u53cd\u5e94\uff0c\u5305\u62ec\u809d\u529f\u80fd\u635f\u5bb3\u3001\u808c\u75c5\u53ca\u65b0\u53d1\u7cd6\u5c3f\u75c5\u7b49\u3002<\/p>\n

\u6211\u56fd\u4eba\u7fa4\u5bf9\u5927\u5242\u91cf\u4ed6\u6c40\u7c7b\u836f\u7269\u7684\u8010\u53d7\u6027\u8f83\u6b27\u7f8e\u4eba\u7fa4\u5dee\uff0c\u57fa\u4e8e\u7597\u6548\u3001\u5b89\u5168\u6027\u3001\u8010\u53d7\u6027\u548c\u6cbb\u7597\u8d39\u7528\u7684\u7efc\u5408\u8003\u8651\uff0c\u4e0d\u5efa\u8bae\u4f7f\u7528\u9ad8\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\uff0c\u63a8\u8350\u4f7f\u7528\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u4f5c\u4e3a\u521d\u59cb\u964d\u8102\u65b9\u6848\uff3b30\uff0c 69\u201178\uff3d<\/sup> \u3002\u76ee\u524d\u56fd\u5185\u4e34\u5e8a\u4e0a\u6709\u6d1b\u4f10\u4ed6\u6c40\u3001\u8f9b\u4f10\u4ed6\u6c40\u3001\u666e\u4f10\u4ed6\u6c40\u3001\u6c1f\u4f10\u4ed6\u6c40\u3001\u963f\u6258\u4f10\u4ed6\u6c40\u3001\u745e\u8212\u4f10\u4ed6\u6c40\u548c\u5339\u4f10\u4ed6\u6c40\uff0c\u4e0d\u540c\u79cd\u7c7b\u4e0e\u5242\u91cf\u7684\u4ed6\u6c40\u7c7b\u836f\u7269\u7684\u964d\u80c6\u56fa\u9187\u5e45\u5ea6\u6709\u4e00\u5b9a\u5dee\u522b\uff0c\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u662f\u6307\u6bcf\u65e5\u5242\u91cf\u53ef\u964d\u4f4eLDL\u2011C 25%~50%\uff08\u88684\uff09\u3002\u6b64\u5916\uff0c\u8840\u8102\u5eb7\u4f5c\u4e3a\u964d\u8102\u4e2d\u6210\u836f\uff0c\u5176\u964d\u8102\u673a\u5236\u7c7b\u4f3c\u4e8e\u4ed6\u6c40\u7c7b\u836f\u7269\uff0cCCSPS\u7814\u7a76\u7cd6\u5c3f\u75c5\u4e9a\u7ec4\u5206\u6790\u8bc1\u5b9e\uff0c\u8840\u8102\u5eb7\u53ef\u4ee5\u6709\u6548\u964d\u4f4eLDL\u2011C\u6c34\u5e73\uff0c\u6539\u5584\u8840\u8102\u8c31\uff0c\u663e\u8457\u964d\u4f4e\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u53d1\u751f\u7387\u4ee5\u53ca\u51a0\u5fc3\u75c5\u6b7b\u4ea1\u7387\uff0c\u4e14\u4e0d\u826f\u53cd\u5e94\u5c11\uff3b89\uff3d <\/sup>\u3002\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u75974~6\u5468\u5185\u5982LDL\u2011C\u4ecd\u4e0d\u80fd\u8fbe\u6807\uff0c\u5e94\u8003\u8651\u8054\u5408\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u548c\uff08\u6216\uff09PCSK9\u6291\u5236\u5242\u6cbb\u7597\uff3b26\u201128\uff0c 79\u201182\uff3d <\/sup>\u3002<\/p>\n

2.\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\uff1a\u5305\u62ec\u4f9d\u6298\u9ea6\u5e03\u3001\u6d77\u535a\u9ea6\u5e03\uff0c\u4e3b\u8981\u901a\u8fc7\u9009\u62e9\u6027\u4f5c\u7528\u4e8e\u5c0f\u80a0\u9ecf\u819c\u5237\u72b6\u7f18\u7684\u5c3c\u66fc\u2011\u5339\u514bC1\u578b\u7c7b\u4f3c\u86cb\u767d1\uff0c\u6291\u5236\u80a0\u9053\u5bf9\u81b3\u98df\u548c\u80c6\u6c41\u80c6\u56fa\u9187\u7684\u5438\u6536\u3002\u7814\u7a76\u8bc1\u5b9e\uff0c\u4f9d\u6298\u9ea6\u5e03\u4e0e\u4e0d\u540c\u79cd\u7c7b\u4ed6\u6c40\u7c7b\u836f\u7269\u8054\u7528\u65f6\uff0c\u53ef\u4f7f LDL\u2011C \u8fdb\u4e00\u6b65\u964d\u4f4e 18%~20%\u5de6\u53f3\uff0c\u4ece\u800c\u4f7fLDL\u2011C\u964d\u5e45\u5927\u4e8e50%\uff0c\u4e14\u4e0d\u589e\u52a0\u4ed6\u6c40\u7c7b\u836f\u7269\u7684\u4e0d\u826f\u53cd\u5e94\uff3b79\u201180\uff0c 90\uff3d<\/sup> \u3002IMPROVE\u2011IT\u7814\u7a76\u4e9a\u7ec4\u5206\u6790\u663e\u793a\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u8054\u7528\u4f9d\u6298\u9ea6\u5e03\u53ef\u4e3a\u5408\u5e76\u7cd6\u5c3f\u75c5\u7684\u6025\u6027\u51a0\u72b6\u52a8\u8109\u7efc\u5408\u5f81\u60a3\u8005\u5e26\u6765\u66f4\u5927\u83b7\u76ca\uff0c\u5176\u4e2d\u5fc3\u808c\u6897\u6b7b\u3001\u7f3a\u8840\u6027\u8111\u5352\u4e2d\u548c\u4e3b\u8981\u7ec8\u70b9\u4e8b\u4ef6\u53d1\u751f\u98ce\u9669\u5206\u522b\u964d\u4f4e24%\u300129%\u548c15%\uff3b26\uff0c 79\uff3d<\/sup> \u3002<\/p>\n

\u6b64\u5916\uff0c\u5176\u4ed6\u4e34\u5e8a\u7814\u7a76\u7684\u4e9a\u7ec4\u5206\u6790\u4e5f\u63d0\u793a\uff0c\u5728\u4ed6\u6c40\u7c7b\u836f\u7269\u57fa\u7840\u4e0a\u8054\u7528\u4f9d\u6298\u9ea6\u5e03\u53ef\u51cf\u5c11\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u4e0d\u826f\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u3002\u4e00\u9879\u57fa\u4e8e\u4e1c\u4e9a\u4eba\u7fa4\u7684\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u5728 ASCVD \u60a3\u8005\u4e2d\uff0c\u745e\u8212\u4f10\u4ed6\u6c40\/\u4f9d\u6298\u9ea6\u5e03\u5355\u7247\u590d\u65b9\u5236\u5242\uff0810 mg\/10 mg\uff09\u8f83\u9ad8\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u5355\u836f\u6cbb\u7597\u6709\u66f4\u9ad8\u7684LDL\u2011C\u8fbe\u6807\u7387\u548c\u66f4\u597d\u7684\u8010\u53d7\u6027\uff0c\u800c\u5728\u8fdb\u4e00\u6b65\u964d\u4f4e\u5fc3\u8111\u8840\u7ba1\u4e8b\u4ef6\u53d1\u751f\u98ce\u9669\u65b9\u9762\u4e0d\u52a3\u4e8e\u9ad8\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u5355\u836f\u6cbb\u7597\uff3b80\uff3d<\/sup> \uff0c\u4e14\u8be5\u7814\u7a76\u7684\u4e9a\u7ec4\u5206\u6790\u663e\u793a\uff0c\u5728\u7cd6\u5c3f\u75c5\u60a3\u8005\u4e2d\u8fd9\u79cd\u8054\u5408\u964d\u8102\u6cbb\u7597\u7684\u826f\u597d\u7597\u6548\u53ca\u5b89\u5168\u6027\u4ecd\u5f97\u4ee5\u4fdd\u7559\uff3b91\uff3d<\/sup> \u3002\u56e0\u6b64\uff0c\u5bf9\u4e8e\u6781\u9ad8\u5371\u548c\u8d85\u9ad8\u5371\u60a3\u8005\uff0c\u4e3a\u8fbe\u5230>50%\u7684LDL\u2011C\u964d\u5e45\uff0c\u53ef\u76f4\u63a5\u542f\u52a8\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u8054\u5408\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u6cbb\u7597\uff0c\u4e3a\u63d0\u9ad8\u60a3\u8005\u7684\u4f9d\u4ece\u6027\uff0c\u53ef\u8003\u8651\u9009\u62e9\u4ed6\u6c40\u7c7b\u836f\u7269\/\u4f9d\u6298\u9ea6\u5e03\u5355\u7247\u590d\u65b9\u5236\u5242\u3002\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u5728\u7cd6\u5c3f\u75c5\u60a3\u8005\u964d\u80c6\u56fa\u9187\u6cbb\u7597\u4e2d\u7684\u4e3b\u8981\u5faa\u8bc1\u4f9d\u636e\u89c1\u9644\u88683\u3002<\/p>\n

3.PCSK9 \u6291\u5236\u5242\uff1a\u4e3b\u8981\u901a\u8fc7\u6291\u5236 LDL \u53d7\u4f53\u964d\u89e3\uff0c\u589e\u52a0\u8840\u6e05LDL\u7684\u6e05\u9664\u800c\u964d\u4f4eLDL\u2011C\u6c34\u5e73\u3002\u76ee\u524d\u83b7\u6279\u7684 PCSK9 \u6291\u5236\u5242\u5305\u62ec\u7ade\u4e89\u6027\u7ed3\u5408\u5faa\u73af\u4e2dPCSK9\u7684\u4e24\u79cd\u5168\u4eba\u6e90\u5355\u514b\u9686\u6297\u4f53\uff0c\u5373\u963f\u5229\u897f\u5c24\u5355\u6297\u548c\u4f9d\u6d1b\u5c24\u5355\u6297\uff0c\u4ee5\u53ca\u9776\u5411 PCSK9 \u7684\u5c0f\u5206\u5b50\u5e72\u6270RNA\u836f\u7269\u82f1\u514b\u53f8\u5170\u3002\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0cPCSK9\u6291\u5236\u5242\uff08\u5305\u62ec\u4f9d\u6d1b\u5c24\u5355\u6297\u3001\u963f\u5229\u897f\u5c24\u5355\u6297\u548c\u82f1\u514b\u53f8\u5170\uff09\u53ef\u663e\u8457\u964d\u4f4e\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u5e73\u5747 LDL\u2011C \u6c34\u5e73\uff0c\u964d\u5e45\u8fbe50%~70%\uff3b92\uff3d<\/sup> \u3002\u540c\u65f6\uff0cPCSK9 \u6291\u5236\u5242\u5bf9\u5176\u4ed6\u8840\u8102\u7ec4\u5206\u4ea6\u6709\u660e\u663e\u6539\u5584\uff0c\u53ef\u4f7f TG \u6c34\u5e73\u964d\u4f4e 10%~30%\uff0cApoB \u6c34\u5e73\u964d\u4f4e 35%~41%\uff0cLp\uff08a\uff09\u6c34\u5e73\u964d\u4f4e 20%~30%\uff3b93\u201195\uff3d<\/sup> \u3002BANTING\u7814\u7a76 \uff3b96\uff3d <\/sup>\u548cBERSON\u7814\u7a76 \uff3b97\u201198\uff3d<\/sup> \u7ed3\u679c\u8fdb\u4e00\u6b65\u8bc1\u5b9e\uff0cPCSK9 \u5355\u514b\u9686\u6297\u4f53\u53ef\u52a9\u529b\u5927\u591a\u6570ASCVD \u9ad8\u5371\/\u6781\u9ad8\u5371\u7684 T2DM \u60a3\u8005\u8840\u8102\u5feb\u901f\u8fbe\u6807\uff0c\u5b89\u5168\u6027\u3001\u8010\u53d7\u6027\u826f\u597d\uff0c\u4e14\u4e0d\u5f71\u54cd\u8840\u7cd6\u6c34\u5e73\u3002<\/p>\n

\u6b64\u5916\uff0c\u591a\u9879\u5927\u89c4\u6a21\u4e34\u5e8a\u7814\u7a76\uff0c\u5305\u62ecFOURIER\u7814\u7a76\uff3b81\uff3d<\/sup> \u3001ODYSSEY Outcomes\u7814\u7a76\u7cd6\u5c3f\u75c5\u4e9a\u7ec4\u5206\u6790 \uff3b27\uff3d<\/sup>\u4ee5\u53ca ODYSSEY DM\u2011INSULIN \u4e9a\u7ec4\u5206\u6790\uff3b99\uff3d <\/sup>\u7b49\uff0c\u5747\u8bc1\u5b9ePCSK9\u6291\u5236\u5242\u53ef\u663e\u8457\u964d\u4f4e\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u53d1\u751f\u98ce\u9669\uff0c\u4e14\u4e0e LDL\u2011C \u964d\u4f4e\u5e45\u5ea6\u5448\u6b63\u76f8\u5173\uff3b93\uff0c 100\uff3d<\/sup> \u3002\u56e0\u6b64\uff0c\u5bf9\u4e8e\u7cd6\u5c3f\u75c5\u5408\u5e76ASCVD\u60a3\u8005\uff0c\u5f53\u57fa\u7ebf LDL\u2011C \u6c34\u5e73\u8f83\u9ad8\uff08\u672a\u4f7f\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u60a3\u8005LDL\u2011C\u22654.9 mmol\/L\uff1b\u670d\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u60a3\u8005 LDL\u2011C\u22652.6 mmol\/L\uff09\uff0c\u9884\u8ba1\u4ed6\u6c40\u7c7b\u836f\u7269\u8054\u5408\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u6cbb\u7597\u96be\u4ee5\u8fbe\u6807\u65f6\uff0c\u53ef\u8003\u8651\u76f4\u63a5\u8054\u5408PCSK9\u6291\u5236\u5242\u6cbb\u7597\uff3b81\u201182\uff3d<\/sup> \u3002PCSK9\u6291\u5236\u5242\u5728\u7cd6\u5c3f\u75c5\u60a3\u8005\u964d\u80c6\u56fa\u9187\u6cbb\u7597\u4e2d\u7684\u4e3b\u8981\u5faa\u8bc1\u4f9d\u636e\u89c1\u9644\u88684\u3002<\/p>\n

\u5bf9\u4e8e\u4e0d\u80fd\u8010\u53d7\u4ed6\u6c40\u7c7b\u836f\u7269\uff0c\u5373\u5e94\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u540e\u51fa\u73b0\u4e0e\u4ed6\u6c40\u7c7b\u836f\u7269\u76f8\u5173\u7684\u4e34\u5e8a\u4e0d\u826f\u53cd\u5e94\u548c\uff08\u6216\uff09\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u6307\u6807\u5f02\u5e38\u7684\u60a3\u8005\uff0c\u4e5f\u5e94\u8003\u8651\u4f7f\u7528\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u548c\uff08\u6216\uff09PCSK9\u6291\u5236\u5242\uff3b28\uff0c 83\u201185\uff3d <\/sup>\u3002\u9664\u4ee5\u4e0a\u4e24\u7c7b\u975e\u4ed6\u6c40\u7c7b\u836f\u7269\u5916\uff0c\u65b0\u578b\u964d\u8102\u836f\u8d1d\u6d3e\u5730\u9178\uff3b101\u2011102\uff3d<\/sup> \u901a\u8fc7\u6291\u5236\u4e09\u78f7\u9178\u817a\u82f7\u2011\u67e0\u6aac\u9178\u88c2\u89e3\u9176\uff0c\u6291\u5236\u809d\u810f\u80c6\u56fa\u9187\u5408\u6210\uff3b103\uff3d<\/sup>\uff0c\u53ef\u5c06 LDL\u2011C \u6c34\u5e73\u964d\u4f4e\u8fbe 30%\uff3b104\uff3d<\/sup>\u3002CLEAR\u2011Outcomes \u7814\u7a76\uff3b102\uff3d<\/sup> \u8bc1\u5b9e\uff0c\u8d1d\u6d3e\u5730\u9178\u53ef\u964d\u4f4eMACE \u98ce\u9669\uff0c\u4e14\u603b\u4f53\u5b89\u5168\u6027\u3001\u8010\u53d7\u6027\u597d\uff0c\u65e0\u76f8\u5173\u808c\u75c5\u3001\u8840\u7cd6\u5f02\u5e38\u7b49\u4e0d\u826f\u53cd\u5e94\uff0c\u4e5f\u53ef\u4f5c\u4e3a\u672a\u6765\u4ed6\u6c40\u7c7b\u836f\u7269\u4e0d\u8010\u53d7\u60a3\u8005\u7684\u4e00\u79cd\u9009\u62e9\u3002\u6b64\u5916\uff0c\u8102\u5fc5\u6cf0\u3001\u591a\u5eff\u70f7\u9187\u7b49\u8010\u53d7\u6027\u826f\u597d\u7684\u964d\u80c6\u56fa\u9187\u836f\u7269\u4e5f\u53ef\u4f5c\u4e3a\u4ed6\u6c40\u7c7b\u836f\u7269\u4e0d\u8010\u53d7\u65f6\u7684\u66ff\u4ee3\u836f\u7269\u3002<\/p>\n

\u4f7f\u7528\u4ee5\u4e0a\u964d\u80c6\u56fa\u9187\u836f\u7269\u4f7f\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684LDL\u2011C \u8fbe\u6807\u540e\uff0c\u5e94\u660e\u786e\u975e HDL\u2011C \u662f\u5426\u8fbe\u6807\u3002\u975eHDL\u2011C\u5305\u542bLDL\u2011C\u548c\u6b8b\u7c92\u80c6\u56fa\u9187\uff0c\u7cd6\u5c3f\u75c5\u60a3\u8005\u6b8b\u7c92\u80c6\u56fa\u9187\u6c34\u5e73\u5347\u9ad8\u4e0eTG\u6c34\u5e73\u5347\u9ad8\u5bc6\u5207\u76f8\u5173\uff0c\u964d\u4f4eTG\u6c34\u5e73\u662f\u964d\u4f4e\u6b8b\u7c92\u80c6\u56fa\u9187\u6c34\u5e73\u7684\u4e3b\u8981\u9014\u5f84\u3002\u964d\u4f4e\u7cd6\u5c3f\u75c5\u60a3\u8005TG\u6c34\u5e73\u7684\u4e3b\u8981\u63aa\u65bd\u5305\u62ec\u4e25\u683c\u7684\u751f\u6d3b\u65b9\u5f0f\u5e72\u9884\u3001\u4f18\u5316\u8840\u7cd6\u7ba1\u7406\u548c\u5fc5\u8981\u65f6\u5e94\u7528\u964dTG\u836f\u7269\u3002<\/p>\n

\u4e09\u3001\u964dTG\u6cbb\u7597\u7b56\u7565<\/p>\n

\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684TG\u7ba1\u7406\u7b56\u7565\u89c1\u88685\u3002<\/p>\n<\/p>\n

\u7cd6\u5c3f\u75c5\u60a3\u8005\u5408\u5e76\u9ad8TG\u8840\u75c7\u65f6\uff0c\u9700\u8bc4\u4f30\u5f15\u8d77\u9ad8TG\u8840\u75c7\u7684\u5176\u4ed6\u7ee7\u53d1\u56e0\u7d20\uff0c\u5305\u62ec\u7532\u72b6\u817a\u529f\u80fd\u51cf\u9000\u75c7\u3001\u80be\u75c5\u7efc\u5408\u5f81\u3001\u6162\u6027\u809d\u75c5\u548c\u5f15\u8d77TG\u6c34\u5e73\u5347\u9ad8\u7684\u836f\u7269\u7b49\u3002\u5728\u7ea0\u6b63\u4ee5\u4e0a\u7ee7\u53d1\u539f\u56e0\u7684\u540c\u65f6\u4ea6\u4e0d\u53ef\u5ffd\u7565\u4e25\u683c\u751f\u6d3b\u65b9\u5f0f\u7ba1\u7406\u3002\u7814\u7a76\u663e\u793a\uff0c\u5f3a\u5316\u996e\u98df\u3001\u8fd0\u52a8\u7279\u522b\u662f\u51cf\u91cd\u7b49\u751f\u6d3b\u65b9\u5f0f\u7ba1\u7406\uff0c\u4e0d\u4ec5\u6709\u52a9\u4e8e\u8840\u7cd6\u63a7\u5236\uff0c\u8fd8\u53ef\u964d\u4f4eTG\u6c34\u5e73\uff0c\u540c\u65f6\u53ef\u5c06LDL\u2011C\u548c\u975eHDL\u2011C\u6c34\u5e73\u964d\u4f4e\u8fbe5%~15%\uff3b65\uff0c 107\uff3d<\/sup> \u3002\u4ee3\u8c22\u624b\u672f\u4f5c\u4e3a\u4e00\u79cd\u6709\u521b\u7684\u4f53\u91cd\u7ba1\u7406\u7b56\u7565\uff0c\u53ef\u663e\u8457\u964d\u4f4eTG\u548c\u975eHDL\u2011C\u6c34\u5e73\u4ee5\u53caASCVD\u98ce\u9669\uff3b108\u2011109\uff3d<\/sup> \u3002<\/p>\n

\u5982\u5728\u4e25\u683c\u751f\u6d3b\u65b9\u5f0f\u7ba1\u7406\u4e0b\u7cd6\u5c3f\u75c5\u60a3\u8005\u8840\u7cd6\u4ecd\u672a\u8fbe\u6807\uff0c\u4ea6\u53ef\u5f71\u54cd TG\u548c\uff08\u6216\uff09\u975e HDL\u2011C\u7684\u63a7\u5236\uff0c\u5e94\u8fdb\u4e00\u6b65\u4f18\u5316\u964d\u7cd6\u7b56\u7565\uff0c\u5728\u4fc3\u8fdb\u8840\u7cd6\u63a7\u5236\u7684\u540c\u65f6\u964d\u4f4eTG\u6c34\u5e73\uff0c\u52a9\u529b\u975eHDL\u2011C\u8fbe\u6807\uff3b110\u2011112\uff3d <\/sup>\u3002\u4f18\u5316\u964d\u7cd6\u7b56\u7565\u63a8\u8350\u4f18\u5148\u9009\u7528\u53ef\u6539\u5584\u8840\u8102\u8c31\u6216\u5fc3\u810f\u9884\u540e\u7684\u964d\u7cd6\u836f\u7269\uff3b113\uff3d <\/sup>\uff0c\u5982\u4e8c\u7532\u53cc\u80cd\u3001\u80f0\u9ad8\u7cd6\u7d20\u6837\u80bd\u20111 \u53d7\u4f53\u6fc0\u52a8\u5242\uff08glucagon like peptide\u20111 receptor agonists\uff0cGLP\u20111RA\uff09\u548c\u94a0\u2011\u8461\u8404\u7cd6\u5171\u8f6c\u8fd0\u86cb\u767d 2 \u6291\u5236\u5242\uff08sodium glucose cotransporter 2 inhibitors\uff0cSGLT2i\uff09\u3002\u4ee5\u4e0a\u4e09\u7c7b\u964d\u7cd6\u836f\u7269\u5747\u53ef\u6539\u5584\u8840\u8102\u8c31\uff0c\u4e14\u5404\u6709\u7279\u70b9\uff0c\u4e34\u5e8a\u4e0a\u53ef\u6839\u636e\u60a3\u8005\u5177\u4f53\u60c5\u51b5\u4f7f\u7528\u3002\u4e8c\u7532\u53cc\u80cd\u548cGLP\u20111RA\u5177\u6709\u660e\u663e\u7684\u51cf\u91cd\u4f18\u52bf\uff0c\u53ef\u964d\u4f4e\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684 TC\u3001TG \u548cLDL\u2011C\u6c34\u5e73\uff3b114\u2011115\uff3d<\/sup> \u3002\u800cSGLT2i\u53ef\u4fc3\u8fdb\u8102\u80aa\u9178\u7684\u5206\u89e3\u548c\u6c27\u5316\uff0c\u51cf\u5c11\u8102\u80aa\u5408\u6210\uff0c\u4e3b\u8981\u964d\u4f4eTG\u5e76\u5347\u9ad8HDL\u2011C\u6c34\u5e73\uff3b110\u2011111\uff0c 116\uff3d <\/sup>\uff0c\u517c\u6709\u6297\u5fc3\u529b\u8870\u7aed\u7684\u4f5c\u7528\u3002<\/p>\n

\u82e5\u8fdb\u4e00\u6b65\u5f3a\u5316\u751f\u6d3b\u65b9\u5f0f\u7ba1\u7406\u4ee5\u53ca\u4f18\u5316\u964d\u7cd6\u7b56\u7565\u4ecd\u4e0d\u80fd\u63a7\u5236TG \u6c34\u5e73<2.3 mmol\/L \u65f6\uff0c\u6839\u636eREDUCE\u2011IT\u7814\u7a76\u548cJELIS\u7814\u7a76\u7ed3\u679c\uff0c\u63a8\u8350\u5728\u964d\u8102\u6cbb\u7597\u65b9\u6848\u4e2d\u52a0\u7528\u5927\u5242\u91cf\u4e8c\u5341\u78b3\u4e94\u70ef\u9178\u4e59\u916f\uff08icosapent ethyl\uff0cIPE\uff09\uff3b51\uff0c 105\uff3d<\/sup> \u4ee5\u964d\u4f4eASCVD\u98ce\u9669\u3002\u7531\u4e8e\u975e\u8bfa\u8d1d\u7279\u4ec5\u5728ACCORD\u7814\u7a76\u7684\u4e9a\u7ec4\u5206\u6790\u4e2d\u663e\u793a\u51fa\u5fc3\u8840\u7ba1\u83b7\u76ca\uff3b49\uff3d <\/sup>\uff0c\u800c\u5305\u542b\u4e8c\u5341\u78b3\u4e94\u70ef\u9178\uff08eicosapentaenoic acid\uff0cEPA\uff09\u548c\u4e8c\u5341\u4e8c\u78b3\u516d\u70ef\u9178\uff08docosahexaenoic acid\uff0cDHA\uff09\u7684\u9ad8\u7eaf\u5ea6\u03c9\u20113\u8102\u80aa\u9178\u4ea6\u4ec5\u5728Meta\u5206\u6790\u4e2d\u663e\u793a\u51fa\u964d\u4f4eASCVD\u98ce\u9669\u7684\u8d8b\u52bf\uff3b48\uff3d <\/sup>\uff0c\u56e0\u6b64\uff0c\u975e\u8bfa\u8d1d\u7279\u3001\u9ad8\u7eaf\u5ea6\u03c9\u20113\u8102\u80aa\u9178\u53ef\u4f5c\u4e3aIPE\u4ee5\u5916\u7528\u6765\u7ba1\u7406TG\u5e76\u51cf\u5c11ASCVD\u98ce\u9669\u7684\u6b21\u9009\u836f\u7269\u3002<\/p>\n

\u6d41\u884c\u75c5\u5b66\u7814\u7a76\u7ed3\u679c\u63d0\u793a\uff0c\u5f53TG\u6c34\u5e73\u663e\u8457\u5347\u9ad8\uff08>5.6 mmol\/L\uff09\u65f6\uff0c\u80f0\u817a\u708e\u53d1\u751f\u98ce\u9669\u589e\u52a0\uff3b106\uff3d<\/sup> \u3002\u4e3a\u964d\u4f4e\u80f0\u817a\u708e\u53d1\u751f\u98ce\u9669\uff0c\u53ef\u91c7\u7528\u8d1d\u7279\u7c7b\u836f\u7269\u3001\u5927\u5242\u91cf\u9ad8\u7eaf\u5ea6\u03c9\u20113\u8102\u80aa\u9178\u6216\u70df\u9178\u7c7b\u836f\u7269\u4e4b\u95f4\u7684\u4e24\u4e24\u6216\u4ee5\u4e0a\u8054\u5408\u6cbb\u7597\u65b9\u6848\uff3b106\uff3d <\/sup>\uff0c\u4ee5\u5c3d\u53ef\u80fd\u964d\u4f4eTG\u6c34\u5e73\u3002<\/p>\n

\u8fd1\u5e74\u6765\uff0c\u8840\u7ba1\u751f\u6210\u7d20\u6837\u86cb\u767d3\u6291\u5236\u5242\uff08\u5168\u4eba\u6e90\u5355\u6297Evinacumab\uff09\u548c\u8f7d\u8102\u86cb\u767dC3\u6291\u5236\u5242\uff08\u53cd\u4e49\u5be1\u6838\u82f7\u9178Volanesorsen\uff09\u7b49\u65b0\u578b\u964dTG\u836f\u7269\u95ee\u4e16\uff0c\u4e34\u5e8a\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u4e24\u8005\u5747\u53ef\u663e\u8457\u964d\u4f4eTG\u6c34\u5e73\uff0c\u540c\u65f6\u53ef\u964d\u4f4e\u975eHDL\u2011C\u548cApoB\u6c34\u5e73\uff3b117\u2011118\uff3d <\/sup>\uff0c\u503c\u5f97\u671f\u5f85\u3002<\/p>\n

\u56db\u3001\u964d\u4f4eLp\uff08a\uff09\u7684\u6cbb\u7597\u7b56\u7565<\/p>\n

\u964d\u4f4eLp\uff08a\uff09\u7684\u65b0\u836f\u4e3b\u8981\u5305\u62ec\u8f7d\u8102\u86cb\u767d\uff08a\uff09\u53cd\u4e49\u5be1\u6838\u82f7\u9178\uff08Pelacarsen\uff09\u548c\u8f7d\u8102\u86cb\u767d\uff08a\uff09\u5c0f\u5e72\u6270 RNA\uff08Olpasiran\u3001SLN360\uff09\u3002\u5c3d\u7ba1\u2160\u671f\u7814\u7a76\u663e\u793a\u4e24\u8005\u5747\u53ef\u663e\u8457\u964d\u4f4eLp\uff08a\uff09\u6c34\u5e73\uff0c\u4f46\u5927\u89c4\u6a21\u3001\u56fd\u9645\u591a\u4e2d\u5fc3\u3001\u5fc3\u8840\u7ba1\u786c\u7ec8\u70b9\u7684\u4e34\u5e8a\u7814\u7a76\u4ecd\u5728\u8fdb\u884c\u4e2d\u3002\u56e0\u6b64\uff0c\u76ee\u524d\u5c1a\u65e0\u9488\u5bf9Lp\uff08a\uff09\u6cbb\u7597\u7684\u836f\u7269\u5e94\u7528\u4e8e\u4e34\u5e8a\uff0c\u5bf9\u4e8eLp\uff08a\uff09\u6c34\u5e73\u5347\u9ad8\u7684\u60a3\u8005\uff0c\u4ecd\u4ee5\u8fdb\u4e00\u6b65\u964d\u4f4e\u80c6\u56fa\u9187\u6c34\u5e73\u4e3a\u4e3b\u3002<\/p>\n

\u5728\u964d\u80c6\u56fa\u9187\u836f\u7269\u4e2d\uff0cPCSK9\u6291\u5236\u5242\u53ef\u5c06\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684 Lp\uff08a\uff09\u6c34\u5e73\u964d\u4f4e\u7ea6 20%~30%\uff0c\u4e14\u663e\u8457\u51cf\u5c11MACE\u53d1\u751f\uff0c\u53ef\u4f5c\u4e3a\u4e34\u5e8a\u7528\u836f\u9009\u62e9\uff3b119\uff3d<\/sup> \u3002\u800c\u70df\u9178\u7c7b\u836f\u7269\u548c\u8f7d\u8102\u86cb\u767dB100\u6291\u5236\u5242Mipomersen\u5c3d\u7ba1\u4e5f\u53ef\u5c06Lp\uff08a\uff09\u6c34\u5e73\u964d\u4f4e20%~30%\uff0c\u4f46\u4e24\u8005\u5747\u7f3a\u4e4f\u5fc3\u8840\u7ba1\u83b7\u76ca\u8bc1\u636e\uff0c\u4e14Mipomersen\u5df2\u4e8e2019\u5e74\u64a4\u5e02\uff0c\u5e76\u4e0d\u63a8\u8350\u4f7f\u7528\uff3b120\u2011122\uff3d<\/sup> \u3002<\/p>\n

\u4e94\u3001\u964d\u8102\u836f\u7269\u5bf9\u8840\u7cd6\u7684\u5f71\u54cd\u53ca\u5904\u7406\u7b56\u7565<\/p>\n

\u76ee\u524d\uff0c\u964d\u8102\u836f\u7269\u5f71\u54cd\u8840\u7cd6\u7684\u673a\u5236\u5c1a\u672a\u5b8c\u5168\u6e05\u695a\u3002\u4e00\u65b9\u9762\uff0c\u4e0e\u964d\u8102\u836f\u7269\u5f71\u54cd\u80f0\u5c9b\u03b2\u7ec6\u80de\u672c\u8eab\u5206\u6ccc\u80f0\u5c9b\u7d20\u6709\u5173\uff1b\u53e6\u4e00\u65b9\u9762\uff0c\u4e0e\u964d\u8102\u836f\u7269\u5f71\u54cd\u80f0\u5c9b\u7d20\u654f\u611f\u6027\uff0c\u7ee7\u800c\u5f71\u54cd\u80f0\u817a\u4ee5\u5916\u7ec4\u7ec7\u5668\u5b98\uff08\u5982\u8102\u80aa\u3001\u808c\u8089\u7b49\uff09\u7684\u7cd6\u4ee3\u8c22\u6709\u5173\uff3b123\uff3d <\/sup>\u3002\u76ee\u524d\uff0c\u5927\u89c4\u6a21\u4e34\u5e8a\u7814\u7a76\u6216Meta\u5206\u6790\u7ed3\u679c\u63d0\u793a\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u548c\u70df\u9178\u7c7b\u836f\u7269\u5bf9\u8840\u7cd6\u63a7\u5236\u4e0d\u5229\u5e76\u6709\u589e\u52a0\u65b0\u53d1\u7cd6\u5c3f\u75c5\u7684\u98ce\u9669\uff3b72\uff0c 123\u2011126\uff3d<\/sup> \u3002\u800c\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u3001PCSK9\u6291\u5236\u5242\u3001\u666e\u7f57\u5e03\u8003\u3001\u8d1d\u6d3e\u5730\u9178\u3001\u8d1d\u7279\u7c7b\u836f\u7269\u3001\u9ad8\u7eaf\u5ea6\u03c9\u20113\u8102\u80aa\u9178\u5bf9\u8840\u7cd6\u8c03\u8282\u5448\u4e2d\u6027\u4f5c\u7528\uff0c\u90e8\u5206\u7814\u7a76\u7ed3\u679c\u8fd8\u663e\u793a\u4e0a\u8ff0\u836f\u7269\u53ef\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u6539\u5584\u7cd6\u4ee3\u8c22\u3001\u51cf\u8f7b\u80f0\u5c9b\u7d20\u62b5\u6297\u4ee5\u53ca\u8102\u80aa\u809d\uff3b26\uff0c 80\uff0c 123\uff3d <\/sup>\u3002\u80c6\u6c41\u9178\u87af\u5408\u5242\u867d\u53ef\u540c\u65f6\u6539\u5584\u7cd6\u8102\u4ee3\u8c22\uff0c\u4f46\u964d\u8102\u6548\u679c\u8f83\u5f31\uff3b27\u201128\uff0c 127\uff3d<\/sup> \uff0c\u6d88\u5316\u9053\u4e0d\u826f\u53cd\u5e94\u8f83\u5927\uff0c\u6211\u56fd\u4e34\u5e8a\u5e94\u7528\u751a\u5c11\u3002\u5bf9\u4e8e\u964d\u4f4eLp\uff08a\uff09\u7684\u65b0\u836f\u76ee\u524d\u4e34\u5e8a\u7814\u7a76\u4ecd\u5728\u8fdb\u884c\u4e2d\uff0c\u5176\u957f\u671f\u5e94\u7528\u5bf9\u8840\u7cd6\u7684\u5f71\u54cd\u5c1a\u4e0d\u660e\u786e\u3002<\/p>\n

\u9274\u4e8e\u4ed6\u6c40\u7c7b\u836f\u7269\u5bf9\u5fc3\u8840\u7ba1\u7684\u4fdd\u62a4\u4f5c\u7528\u8fdc\u5927\u4e8e\u5176\u5bf9\u8840\u7cd6\u63a7\u5236\u7684\u4e0d\u5229\u6548\u5e94\uff08HbA 1c<\/sub> \u5e73\u5747\u5347\u9ad80.3%\u6216\u66f4\u5c11\uff09\u4ee5\u53ca\u65b0\u53d1\u7cd6\u5c3f\u75c5\u7684\u98ce\u9669\uff0c\u6545\u4e0d\u63a8\u8350\u7cd6\u5c3f\u75c5\u60a3\u8005\u56e0\u8840\u7cd6\u63a7\u5236\u4e0d\u826f\u800c\u505c\u670d\u4ed6\u6c40\u7c7b\u836f\u7269\u3002\u7531\u4e8e\u4ed6\u6c40\u7c7b\u836f\u7269\u5bf9\u8840\u7cd6\u63a7\u5236\u4e0d\u5229\u7684\u6548\u5e94\u548c\u65b0\u53d1\u7cd6\u5c3f\u75c5\u98ce\u9669\u4e0e\u5242\u91cf\u76f8\u5173\uff0c\u4e14\u4e0d\u540c\u79cd\u7c7b\u4ed6\u6c40\u7c7b\u836f\u7269\u5bf9\u8840\u7cd6\u7684\u5f71\u54cd\u4e0d\u540c\uff0c\u4f8b\u5982\u963f\u6258\u4f10\u4ed6\u6c40\u3001\u745e\u8212\u4f10\u4ed6\u6c40\u3001\u8f9b\u4f10\u4ed6\u6c40\u53ca\u6c1f\u4f10\u4ed6\u6c40\u5728\u6b63\u5e38\u4eba\u548cT2DM\u60a3\u8005\u4e2d\u5bf9\u8840\u7cd6\u8c03\u63a7\u5747\u5177\u6709\u7c7b\u4f3c\u7684\u4e0d\u826f\u5f71\u54cd\uff0c\u800c\u5339\u4f10\u4ed6\u6c40\u548c\u666e\u4f10\u4ed6\u6c40\u5bf9\u8840\u7cd6\u8c03\u8282\u5177\u6709\u8f83\u4e2d\u6027\u7684\u4f5c\u7528\uff3b72\uff0c 124\u2011125\uff0c 128\uff3d<\/sup> \u3002\u56e0\u6b64\uff0c\u5bf9\u4e8e\u7cd6\u5c3f\u75c5\u60a3\u8005\uff0c\u9664\u4e86\u5728\u4ed6\u6c40\u7c7b\u836f\u7269\u4f7f\u7528\u524d\u548c\u4f7f\u7528\u8fc7\u7a0b\u4e2d\u76d1\u6d4b\u8840\u7cd6\u6216HbA 1c<\/sub> \u5916\uff0c\u53ef\u5728\u8840\u8102\u63a7\u5236\u8fbe\u6807\u7684\u57fa\u7840\u4e0a\uff0c\u5c3d\u91cf\u9009\u62e9\u4e34\u5e8a\u6548\u4ef7\u6bd4\u9ad8\u7684\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u53ca\u5bf9\u8840\u7cd6\u5f71\u54cd\u8f83\u4e3a\u4e2d\u6027\u7684\u4ed6\u6c40\u7c7b\u836f\u7269\uff0c\u4ee5\u51cf\u5c11\u5176\u5f15\u8d77\u7684\u7cd6\u4ee3\u8c22\u5f02\u5e38\u3002\u82e5\u8840\u8102\u63a7\u5236\u4e0d\u8fbe\u6807\uff0c\u53ef\u8003\u8651\u8054\u7528\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u6216PCSK9\u6291\u5236\u5242\uff0c\u800c\u4e0d\u5efa\u8bae\u589e\u52a0\u4ed6\u6c40\u7c7b\u836f\u7269\u5242\u91cf\uff3b27\u201128\uff0c 80\uff3d<\/sup> \u3002<\/p>\n

\u7814\u7a76\u8868\u660e\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u901a\u8fc7\u964d\u4f4e\u80a0\u9053\u751f\u5b62\u68ad\u83cc\uff0c\u6291\u5236\u9e45\u53bb\u6c27\u80c6\u9178\u5411\u718a\u53bb\u6c27\u80c6\u9178\u8f6c\u5316\uff0c\u5f15\u8d77\u80a0\u9053GLP\u20111\u5206\u6ccc\u51cf\u5c11\uff0c\u4ece\u800c\u5bfc\u81f4\u673a\u4f53\u7cd6\u4ee3\u8c22\u5f02\u5e38\u548c\u80f0\u5c9b\u7d20\u62b5\u6297\uff3b26\uff0c 80\uff0c 123\uff0c 129\uff3d<\/sup> \uff0c\u800c\u8054\u5408\u4f7f\u7528\u718a\u53bb\u6c27\u80c6\u9178\u53ef\u4ee5\u9006\u8f6c\u4ed6\u6c40\u7c7b\u836f\u7269\u5f15\u8d77\u7684\u7cd6\u8010\u91cf\u5f02\u5e38\uff0c\u540c\u65f6\u4e0d\u6539\u53d8\u5176\u672c\u8eab\u7684\u964d\u8102\u7597\u6548\uff0c\u63d0\u793a\u4ed6\u6c40\u7c7b\u836f\u7269\u8054\u5408\u718a\u53bb\u6c27\u80c6\u9178\u53ef\u80fd\u6210\u4e3a\u672a\u6765\u4e00\u79cd\u65b0\u578b\u964d\u8102\u6cbb\u7597\u7b56\u7565\uff3b26\uff0c 80\uff0c 123\uff0c 129\uff3d <\/sup>\u3002\u540c\u65f6\uff0c\u5bf9\u4e8e\u7cd6\u5c3f\u75c5\u60a3\u8005\uff0c\u8fd8\u5e94\u6ce8\u610f\u51cf\u8f7b\u4f53\u91cd\u3001\u5408\u7406\u81b3\u98df\u548c\u4f18\u5316\u964d\u7cd6\u6cbb\u7597\u65b9\u6848\u3002\u70df\u9178\u7c7b\u836f\u7269\u53ef\u5bfc\u81f4\u7cd6\u4ee3\u8c22\u5f02\u5e38\u6216\u7cd6\u8010\u91cf\u6076\u5316\uff0c\u5bf9\u7cd6\u5c3f\u75c5\u60a3\u8005\u65e0\u5fc3\u8840\u7ba1\u83b7\u76ca\uff0c\u4e00\u822c\u4e0d\u63a8\u8350\u5728\u7cd6\u5c3f\u75c5\u60a3\u8005\u4e2d\u4f7f\u7528\uff0c\u82e5\u5fc5\u987b\u4f7f\u7528\uff0c\u5e94\u5b9a\u671f\u76d1\u6d4b\u8840\u7cd6\u6c34\u5e73\uff3b68\uff0c 123\uff3d<\/sup> \u3002<\/p>\n

\u516d\u3001\u964d\u8102\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u7684\u76d1\u6d4b<\/p>\n

\u5bf9\u4e8e\u9996\u6b21\u670d\u7528\u964d\u8102\u836f\u7269\u8005\uff0c\u5e94\u5728\u7528\u836f4~6\u5468\u65f6\u590d\u67e5\u8840\u8102\u3001\u809d\u9176\u3001\u808c\u9178\u6fc0\u9176\u7b49\u6307\u6807\u3002\u5982\u8840\u8102\u6307\u6807\u80fd\u8fbe\u6807\uff0c\u4e14\u65e0\u836f\u7269\u4e0d\u826f\u53cd\u5e94\uff0c\u9010\u6b65\u6539\u4e3a\u6bcf3~6\u4e2a\u6708\u590d\u67e5\u4e00\u6b21\u3002\u5982\u6cbb\u75974~6\u5468\u540e\uff0c\u8840\u8102\u4ecd\u672a\u8fbe\u6807\uff0c\u9700\u53ca\u65f6\u8c03\u6574\u964d\u8102\u836f\u7269\u5242\u91cf\u6216\u79cd\u7c7b\uff0c\u6216\u8054\u5408\u5e94\u7528\u4e0d\u540c\u4f5c\u7528\u673a\u5236\u7684\u964d\u8102\u836f\u7269\u3002\u6bcf\u5f53\u8c03\u6574\u964d\u8102\u836f\u7269\u79cd\u7c7b\u6216\u5242\u91cf\u65f6\uff0c\u90fd\u5e94\u5728\u6cbb\u75974~6\u5468\u65f6\u590d\u67e5\u3002\u6b64\u5916\uff0c\u9274\u4e8e\u957f\u671f\u670d\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u53ef\u80fd\u5f15\u8d77\u7cd6\u4ee3\u8c22\u5f02\u5e38\uff0c\u5e94\u540c\u65f6\u52a0\u5f3a\u5bf9\u8840\u7cd6\u548c\uff08\u6216\uff09HbA1c<\/sub> \u7684\u76d1\u6d4b\uff3b130\uff3d<\/sup> \u3002<\/p>\n

\u7cd6\u5c3f\u75c5\u7279\u6b8a\u4eba\u7fa4\u7684\u964d\u8102\u6cbb\u7597<\/p>\n

\u4e00\u3001\u513f\u7ae5\u548c\u9752\u5c11\u5e74<\/p>\n

\u5efa\u8bae\u5bf9\u8bca\u65ad\u4e3a\u7cd6\u5c3f\u75c5\u768410\u5c81\u4ee5\u4e0a\u513f\u7ae5\u548c\u9752\u5c11\u5e74\u5728\u8840\u7cd6\u5f97\u5230\u63a7\u5236\u540e\u6216\u63a5\u53d7\u964d\u7cd6\u836f\u7269\u6cbb\u75973\u4e2a\u6708\u540e\u8fdb\u884c\u8840\u8102\u68c0\u6d4b\u548c\u8bc4\u4f30\u3002\u513f\u7ae5\u4e0e\u9752\u5c11\u5e74\u7cd6\u5c3f\u75c5\u60a3\u8005\u7406\u60f3\u7684\u8840\u8102\u6c34\u5e73\u4e3a LDL\u2011C<2.6 mmol\/L\uff0cHDL\u2011C>0.9 mmol\/L\uff0c TG<1.7 mmol\/L\uff0c \u975e HDL\u2011C<3.4 mmol\/L\uff3b131\uff3d<\/sup> \u3002<\/p>\n

\u5bf9\u4e8e\u6301\u7eed\u8840\u8102\u5f02\u5e38\u8005\u5e94\u8fdb\u884c\u5e72\u9884\u5c06\u8840\u8102\u63a7\u5236\u5728\u7406\u60f3\u8303\u56f4\u5185\u3002\u5e72\u9884\u63aa\u65bd\u4ee5\u4f4e\u8102\u4e0e\u9ad8\u7ea4\u7ef4\u996e\u98df\u3001\u89c4\u5f8b\u8fd0\u52a8\u3001\u4fdd\u6301\u7406\u60f3\u4f53\u91cd\u53ca\u4fdd\u6301\u5145\u8db3\u7761\u7720\u7b49\u5065\u5eb7\u751f\u6d3b\u65b9\u5f0f\u53ca\u4f18\u5316\u8840\u7cd6\u63a7\u5236\u4e3a\u57fa\u7840\u3002\u5408\u5e76\u5bb6\u65cf\u6027\u9ad8\u80c6\u56fa\u9187\u8840\u75c7\u8005\u53ef\u8003\u8651\u542f\u52a8\u964d\u8102\u6cbb\u7597\uff0c\u964d\u8102\u836f\u7269\u5305\u62ec\u4ed6\u6c40\u7c7b\u836f\u7269\u3001\u4f9d\u6298\u9ea6\u5e03\u3001\u80c6\u6c41\u9178\u87af\u5408\u5242\u548cPCSK9\u6291\u5236\u5242\uff0c\u4f46\u8fd9\u4e9b\u836f\u7269\u5728\u513f\u7ae5\u548c\u9752\u5c11\u5e74\u4e2d\u4f7f\u7528\u7684\u957f\u671f\u5b89\u5168\u6027\u8bc1\u636e\u6709\u9650\u3002<\/p>\n

\u4e8c\u3001\u226575\u5c81\u8001\u5e74\u4eba<\/p>\n

\u7cd6\u5c3f\u75c5\u5df2\u6210\u4e3a\u8001\u5e74\u4eba\u4e2d\u5e38\u89c1\u7684\u75be\u75c5\u4e4b\u4e00\uff0c\u6211\u56fd\u8001\u5e74\u4eba\u4e2d\u7cd6\u5c3f\u75c5\u60a3\u75c5\u7387\u5df2\u9ad8\u8fbe30%\uff3b132\uff3d <\/sup>\u3002\u8003\u8651\u5230\u226575\u5c81\u7684\u9ad8\u9f84\u60a3\u8005\u5f88\u5c11\u88ab\u7eb3\u5165\u4e34\u5e8a\u7814\u7a76\uff0c\u226575\u5c81\u7684\u7cd6\u5c3f\u75c5\u60a3\u8005\u662f\u5426\u80fd\u4ece\u964d\u4f4eLDL\u2011C\u7684\u6cbb\u7597\u4e2d\u83b7\u76ca\u5c1a\u7f3a\u5c11\u5145\u5206\u7684\u8bc1\u636e\u3002\u8fd1\u671f\u4e00\u9879Meta\u5206\u6790\u7eb3\u5165\u4e8629\u9879\u5305\u62ec\u4e00\u7ea7\u9884\u9632\u4e0e\u4e8c\u7ea7\u9884\u9632\u7684\u4e34\u5e8a\u7814\u7a76\uff0c\u5176\u7ed3\u679c\u663e\u793a\uff0c\u226575\u5c81\u60a3\u8005\u4ea6\u80fd\u4ece\u964d\u4f4eLDL\u2011C\u7684\u6cbb\u7597\u4e2d\u83b7\u76ca\uff0c\u4e14\u4ed6\u6c40\u7c7b\u836f\u7269\u4e0e\u4f9d\u6298\u9ea6\u5e03\u3001PCSK9\u6291\u5236\u5242\u7b49\u975e\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\u5e26\u6765\u7684\u5fc3\u8111\u8840\u7ba1\u4e8b\u4ef6\u98ce\u9669\u4e0b\u964d\u5e45\u5ea6\u65e0\u660e\u663e\u5dee\u5f02\uff1b\u5728\u5b89\u5168\u6027\u65b9\u9762\uff0c\u964d\u8102\u6cbb\u7597\u5e76\u672a\u589e\u52a0\u226575\u5c81\u60a3\u8005\u53d1\u751f\u80bf\u7624\u3001\u51fa\u8840\u6027\u8111\u5352\u4e2d\u3001\u8ba4\u77e5\u529f\u80fd\u969c\u788d\u548c\u65b0\u53d1\u7cd6\u5c3f\u75c5\u7684\u98ce\u9669\uff3b133\uff3d<\/sup> \u3002<\/p>\n

\u226575\u5c81\u7684\u7cd6\u5c3f\u75c5\u60a3\u8005\u5747\u4e3aASCVD\u6781\u9ad8\u5371\u60a3\u8005\uff0c\u5efa\u8bae\u79ef\u6781\u8fdb\u884c\u964d\u8102\u6cbb\u7597\u3002\u5c3d\u7ba1\u76ee\u524d\u7f3a\u4e4f\u9ad8\u9f84\u8001\u5e74\u60a3\u8005\u4ed6\u6c40\u7c7b\u836f\u7269\u964d\u8102\u6cbb\u7597\u9776\u76ee\u6807\u7684\u968f\u673a\u5bf9\u7167\u7814\u7a76\uff0c\u672c\u5171\u8bc6\u5bf9\u8be5\u7c7b\u60a3\u8005\u7684LDL\u2011C\u76ee\u6807\u503c\u4e5f\u4e0d\u505a\u660e\u786e\u63a8\u8350\uff0c\u4f46\u975e\u4ed6\u6c40\u7c7b\u836f\u7269\u5982\u4f9d\u6298\u9ea6\u5e03\u6216PCSK9\u6291\u5236\u5242\u7684\u76f8\u5173\u968f\u673a\u5bf9\u7167\u7814\u7a76\u7eb3\u5165\u4e86\u226575\u5c81\u60a3\u8005\uff3b28\uff0c 134\uff3d<\/sup> \uff0c\u540c\u65f6\u8003\u8651\u5171\u5b58\u7684\u809d\u80be\u75be\u75c5\u3001\u5408\u5e76\u7528\u836f\u548c\u9884\u671f\u5bff\u547d\uff0c\u5bf9\u4e8e\u226575\u5c81\u7684\u6781\u9ad8\u5371\u60a3\u8005\uff0c\u53ef\u8003\u8651\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u8054\u5408\u975e\u4ed6\u6c40\u7c7b\u836f\u7269\u4f5c\u4e3a\u5f3a\u5316\u964d\u8102\u6cbb\u7597\u7684\u624b\u6bb5\u3002\u7528\u836f\u8fc7\u7a0b\u4e2d\u5e94\u52a0\u5f3a\u5bf9\u809d\u80be\u529f\u80fd\u3001\u808c\u8089\u53d7\u635f\u7b49\u4e0d\u826f\u53cd\u5e94\u7684\u76d1\u6d4b\u3002<\/p>\n

\u4e09\u3001\u5408\u5e76\u6162\u6027\u80be\u810f\u75c5\uff08chronic kidney disease\uff0cCKD\uff09\u7684\u60a3\u8005<\/p>\n

\u7ea6\u6709 30% \u7684 T1DM \u60a3\u8005\u548c 40% \u7684 T2DM \u60a3\u8005\u5408\u5e76CKD\uff3b135\uff3d<\/sup> \u3002\u5408\u5e76CKD\u7684\u7cd6\u5c3f\u75c5\u60a3\u8005\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u98ce\u9669\u663e\u8457\u589e\u52a0\uff0c\u76f4\u63a5\u5f52\u5165ASCVD\u6781\u9ad8\u5371\u4eba\u7fa4\u3002<\/p>\n

\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\u5bf9ASCVD\u98ce\u9669\u7684\u964d\u4f4e\u53d7\u80be\u529f\u80fd\u72b6\u6001\u7684\u5f71\u54cd\u3002\u5bf9\u4e8e\u8f7b\u4e2d\u5ea6\u80be\u529f\u80fd\u4e0d\u5168\u7684\u975e\u900f\u6790\u60a3\u8005\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\u53ef\u663e\u8457\u964d\u4f4e\u5168\u56e0\u6b7b\u4ea1\u98ce\u9669\uff3b136\uff3d<\/sup> \uff0c\u5728\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\u57fa\u7840\u4e0a\u8054\u7528\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u6216 PCSK9 \u6291\u5236\u5242\u4ea6\u53ef\u5e26\u6765\u5fc3\u8840\u7ba1\u83b7\u76ca\uff3b137\u2011139\uff3d<\/sup> \u3002\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\u672a\u80fd\u663e\u8457\u964d\u4f4e\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u5fc3\u8840\u7ba1\u75be\u75c5\u53d1\u751f\u98ce\u9669\uff3b139\u2011141\uff3d<\/sup> \u3002<\/p>\n

CKD\u60a3\u8005\u662f\u4ed6\u6c40\u7c7b\u836f\u7269\u76f8\u5173\u808c\u75c5\u7684\u9ad8\u5371\u4eba\u7fa4\uff0c\u5c24\u5176\u5728\u80be\u529f\u80fd\u8fdb\u884c\u6027\u51cf\u9000\u6216\u4f30\u7b97\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387<30 ml\u00b7min -1<\/sup> \u00b7\uff081.73 m 2<\/sup> \uff09-1 <\/sup>\u65f6\u98ce\u9669\u663e\u8457\u589e\u52a0\uff0c\u4e14\u53d1\u75c5\u98ce\u9669\u4e0e\u4ed6\u6c40\u7c7b\u836f\u7269\u5242\u91cf\u5bc6\u5207\u76f8\u5173\uff0c\u6545\u5e94\u907f\u514d\u5927\u5242\u91cf\u4f7f\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u3002\u4e0d\u540cCKD\u5206\u671f\u65f6\u4ed6\u6c40\u7c7b\u836f\u7269\u7684\u5242\u91cf\u8c03\u6574\u65b9\u6848\u89c1\u8868 6\u3002\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u548cPCSK9\u6291\u5236\u5242\u5bf9\u4e8e\u80be\u529f\u80fd\u53d7\u635f\u60a3\u8005\u662f\u5b89\u5168\u7684\uff0c\u4e0d\u9700\u8981\u8c03\u6574\u5242\u91cf\u3002<\/p>\n<\/p>\n

\u56db\u3001\u5408\u5e76\u4ee3\u8c22\u76f8\u5173\u8102\u80aa\u6027\u809d\u75c5\uff08metabolic associated fatty liver disease\uff0cMAFLD\uff09\u7684\u60a3\u8005<\/p>\n

MAFLD\u6307\u57fa\u4e8e\u75c5\u7406\u5b66\u6216\u5f71\u50cf\u5b66\u5b58\u5728\u8102\u80aa\u809d\u8bc1\u636e\uff0c\u540c\u65f6\u6709\u8d85\u91cd\/\u80a5\u80d6\u3001T2DM\u6216\u4ee3\u8c22\u529f\u80fd\u7d0a\u4e71 3\u9879\u6761\u4ef6\u4e4b\u4e00\u8005\u3002\u7cd6\u5c3f\u75c5\u4e0e MAFLD \u4e92\u4e3a\u5371\u9669\u56e0\u7d20\uff0cT2DM\u60a3\u8005\u4e2dMAFLD\u60a3\u75c5\u7387\u53ef\u9ad8\u8fbe55.5%\uff3b142\uff3d<\/sup> \uff0c\u5408\u5e76T2DM\u7684MAFLD\u60a3\u8005\u809d\u810f\u75c5\u53d8\u8fdb\u5c55\u4e3a\u809d\u786c\u5316\u548c\u809d\u764c\u7684\u98ce\u9669\u66f4\u9ad8\uff3b143\u2011144\uff3d<\/sup> \u3002MAFLD \u662f ASCVD \u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\uff3b145\uff3d<\/sup> \uff0c\u7cd6\u5c3f\u75c5\u5408\u5e76MAFLD\u8005\u6bd4\u4e0d\u5408\u5e76MAFLD\u8005\u5177\u6709\u66f4\u9ad8\u7684ASCVD\u98ce\u9669\uff3b146\u2011149\uff3d<\/sup> \u3002<\/p>\n

\u76ee\u524d\u5c1a\u65e0\u8bc1\u636e\u63d0\u793aT2DM\u5408\u5e76MAFLD\u60a3\u8005\u7684\u8840\u8102\u63a7\u5236\u662f\u5426\u8981\u6c42\u66f4\u4e25\u683c\uff0c\u5728\u964d\u8102\u836f\u7269\u4f7f\u7528\u8fc7\u7a0b\u4e2d\uff0c\u9700\u5173\u6ce8\u8840\u8102\u548c\u809d\u529f\u80fd\u3002\u4ed6\u6c40\u7c7b\u836f\u7269\u672c\u8eab\u53ef\u5f15\u8d77\u809d\u9176\u5347\u9ad8\uff0c\u53d1\u751f\u7387\u7ea61%\uff0c\u5e38\u89c1\u4e8e\u5f00\u59cb\u7528\u836f\u6216\u589e\u52a0\u5242\u91cf\u7684 12 \u5468\u5185\uff0c\u5448\u5242\u91cf\u4f9d\u8d56\u6027\uff0c\u6781\u5c11\u5f15\u8d77\u809d\u529f\u80fd\u8870\u7aed\u3002\u5728\u809d\u529f\u80fd\u6b63\u5e38\u7684MAFLD\u60a3\u8005\u4e2d\u53ef\u4f7f\u7528\u4e2d\u7b49\u5f3a\u5ea6\u4ed6\u6c40\u7c7b\u836f\u7269\u3002\u8840\u6e05\u4e19\u6c28\u9178\u6c28\u57fa\u8f6c\u79fb\u9176\uff08alanine transaminase\uff0cALT\uff09\u6216\u5929\u95e8\u51ac\u6c28\u9178\u6c28\u57fa\u8f6c\u79fb\u9176\uff08aspartate transaminase\uff0cAST\uff09\u5347\u9ad8\u5728\u6b63\u5e38\u503c\u4e0a\u96503\u500d\u5185\u4e14\u603b\u80c6\u7ea2\u7d20\u6c34\u5e73\u6b63\u5e38\u8005\uff0c\u53ef\u5728\u539f\u5242\u91cf\u6216\u51cf\u91cf\u7684\u57fa\u7840\u4e0a\u8fdb\u884c\u89c2\u5bdf\u3002\u5982ALT\u6216AST\u5347\u9ad8\u2265\u6b63\u5e38\u503c\u4e0a\u9650 3 \u500d\uff0c\u5e94\u505c\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\uff0c\u8f7b\u5ea6\u809d\u529f\u80fd\u53d7\u635f\uff08Child\u2011Pugh\u8bc4\u52065~6\u5206\uff09\u60a3\u8005\u53ef\u91c7\u7528\u80c6\u56fa\u9187\u5438\u6536\u6291\u5236\u5242\u6216PCSK9\u6291\u5236\u5242\u66ff\u4ee3\u3002\u5931\u4ee3\u507f\u6027\u809d\u786c\u5316\u548c\u6025\u6027\u809d\u529f\u80fd\u8870\u7aed\u662f\u4ed6\u6c40\u7c7b\u836f\u7269\u7684\u5e94\u7528\u7981\u5fcc\u8bc1\uff3b68\uff0c 150\uff3d<\/sup> \uff0c\u5176\u4ed6\u7c7b\u578b\u964d\u8102\u836f\u7269\u5728\u8fd9\u4e9b\u60a3\u8005\u4e2d\u7684\u4f7f\u7528\u7f3a\u4e4f\u8bc1\u636e\u3002<\/p>\n

\u4e94\u3001\u5408\u5e76\u598a\u5a20\u7684\u60a3\u8005<\/p>\n

\u598a\u5a20\u53ef\u5bfc\u81f4\u8840\u80c6\u56fa\u9187\u6c34\u5e73\u751f\u7406\u6027\u5347\u9ad8\uff0cLDL\u2011C\u6c34\u5e73\u53ef\u5347\u9ad850%\uff1b\u60a3\u8005\u598a\u5a20\u671f\u80c6\u56fa\u9187\u6c34\u5e73\u5f02\u5e38\u5347\u9ad8\u5c06\u589e\u52a0\u65e9\u4ea7\u548c\u80ce\u513f\u52a8\u8109\u7ca5\u6837\u786c\u5316\u7684\u98ce\u9669\uff3b151\uff3d<\/sup> \u3002\u598a\u5a20\u671f\u7684\u8840\u8102\u7ba1\u7406\u91cd\u70b9\u662f\u7b5b\u67e5\uff0c\u4ee5\u53ca\u996e\u98df\u7ba1\u7406\u3001\u5408\u7406\u8fd0\u52a8\u3001\u6212\u70df\u9152\u7b49\u751f\u6d3b\u65b9\u5f0f\u6539\u53d8\uff0c\u5e76\u5c06\u8840\u7cd6\u63a7\u5236\u5728\u9002\u5b9c\u8303\u56f4\uff0c\u964d\u8102\u836f\u7269\u7684\u9009\u62e9\u975e\u5e38\u6709\u9650\uff3b152\uff3d<\/sup> \u3002<\/p>\n

\u57fa\u4e8e\u4ed6\u6c40\u7c7b\u836f\u7269\u5bfc\u81f4\u80ce\u513f\u7578\u5f62\u7684\u52a8\u7269\u5b9e\u9a8c\u548c\u75c5\u4f8b\u62a5\u544a\uff0c\u901a\u5e38\u4e0d\u5efa\u8bae\u598a\u5a20\u671f\u4f7f\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u3002\u5728\u8fd1\u671f2\u9879\u666e\u4f10\u4ed6\u6c40\u76f8\u5173\u968f\u673a\u5bf9\u7167\u7814\u7a76\u53ca\u961f\u5217\u7814\u7a76\u4e2d\uff0c\u672a\u53d1\u73b0\u4ed6\u6c40\u7c7b\u836f\u7269\u589e\u52a0\u51fa\u751f\u7f3a\u9677\u7684\u98ce\u9669\uff3b153\u2011154\uff3d <\/sup>\u3002Meta\u5206\u6790\u7ed3\u679c\u63d0\u793a\uff0c\u4ed6\u6c40\u7c7b\u836f\u7269\u672a\u589e\u52a0\u51fa\u751f\u7f3a\u9677\u98ce\u9669\uff0c\u4f46\u4e0e\u81ea\u53d1\u6027\u6d41\u4ea7\u7684\u98ce\u9669\u589e\u52a0\u76f8\u5173\uff3b155\u2011156\uff3d <\/sup>\u3002\u57fa\u4e8e\u8fd9\u4e9b\u8bc1\u636e\uff0c\u7f8e\u56fdFDA\u57282021\u5e74\u8981\u6c42\u53d6\u6d88\u4ed6\u6c40\u7c7b\u836f\u7269\u7684\u201c\u598a\u5a20X\u7c7b\u201d\u6807\u7b7e\u3002\u5bf9\u4e8e\u65e2\u5f80\u53d1\u751f\u8fc7\u51a0\u72b6\u52a8\u8109\u4e8b\u4ef6\u6216\u6709\u5bb6\u65cf\u6027\u9ad8\u80c6\u56fa\u9187\u8840\u75c7\u7684\u7cd6\u5c3f\u75c5\u598a\u5a20\u671f\u5973\u6027\uff0c\u91c7\u7528\u8840\u6db2\u8102\u86cb\u767d\u5206\u79bb\u6280\u672f\u964d\u4f4e LDL\u2011C \u76f8\u5bf9\u5b89\u5168\u3001\u6709\u6548\uff0c\u4ea6\u53ef\u5728\u591a\u5b66\u79d1\u534f\u5546\u3001\u5145\u5206\u8bc4\u4f30\u5229\u5f0a\u7684\u57fa\u7840\u4e0a\u8c28\u614e\u9009\u62e9\u4ed6\u6c40\u7c7b\u836f\u7269\uff3b68\uff3d<\/sup> \u3002<\/p>\n

\u7cd6\u5c3f\u75c5\u5408\u5e76\u598a\u5a20\u60a3\u8005\u7531\u4e8e\u8425\u517b\u6444\u5165\u548c\u96cc\u6fc0\u7d20\u5206\u6ccc\u589e\u52a0\u800c\u4fc3\u8fdb\u809d\u810fTG\u5408\u6210\u589e\u52a0\uff0c\u81f4\u4f7fTG\u6c34\u5e73\u5f02\u5e38\u5347\u9ad8\u3002\u5c24\u5176\u5728\u598a\u5a20\u665a\u671f\uff0cLPL\u6d3b\u6027\u4e0b\u964d\uff0c\u66f4\u5bb9\u6613\u51fa\u73b0\u4e25\u91cd\u9ad8TG\u8840\u75c7\u548c\u6025\u6027\u80f0\u817a\u708e\u3002\u598a\u5a20\u671f\u53ef\u9009\u7528\u7684\u964dTG\u836f\u7269\u6709\u9650\uff0c\u8d1d\u7279\u7c7b\u836f\u7269\u5728\u598a\u5a20\u671f\u4f7f\u7528\u5c1a\u65e0\u5145\u5206\u7684\u5b89\u5168\u6027\u8bc1\u636e\u3002<\/p>\n

\u5bf9\u4e8e\u7cd6\u5c3f\u75c5\u5408\u5e76\u598a\u5a20\u671f\u9ad8TG\u8840\u75c7\u60a3\u8005\uff0c\u5e94\u4ee5\u751f\u6d3b\u65b9\u5f0f\u6539\u5584\u548c\u996e\u98df\u7ba1\u7406\u4e3a\u57fa\u7840\uff0c\u5728\u4f18\u5316\u8840\u7cd6\u63a7\u5236\u7684\u57fa\u7840\u4e0a\uff0c\u5bf9\u4e25\u91cd\u9ad8 TG \u8840\u75c7\uff08TG>5.6 mmol\/L\uff09\u60a3\u8005\uff0c\u03c9\u20113\u8102\u80aa\u9178\u80fd\u6709\u6548\u5e76\u76f8\u5bf9\u5b89\u5168\u5730\u964d\u4f4eTG\u6c34\u5e73\uff0c\u80f0\u5c9b\u7d20\u548c\u809d\u7d20\u901a\u8fc7\u6fc0\u6d3bLPL\u964d\u4f4eTG\u6c34\u5e73\uff0c\u5bf9\u5b55\u5987\u76f8\u5bf9\u5b89\u5168\uff3b157\uff3d<\/sup> \u3002\u82e5\u53d1\u751f\u80f0\u817a\u708e\u7684\u60a3\u8005\u7ecf\u836f\u7269\u6cbb\u759724~48 h\u540e\u8840\u6e05TG\u6c34\u5e73\u4ecd>11.3 mmol\/L\u6216\u964d\u5e45\u672a\u8fbe50%\uff0c\u53ef\u8003\u8651\u8fdb\u884c\u8102\u86cb\u767d\u5206\u79bb\u6cbb\u7597\uff3b158\uff3d<\/sup> \u3002<\/p>\n

\u603b\u7ed3\u4e0e\u5c55\u671b<\/p>\n

\u6211\u56fd\u7cd6\u5c3f\u75c5\u60a3\u8005\u4eba\u6570\u5c45\u4e16\u754c\u4e4b\u9996\uff0c\u6709\u6548\u7ba1\u7406\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u8840\u8102\u5f02\u5e38\u3001\u964d\u4f4e\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u98ce\u9669\u5bf9\u4e8e\u5b9e\u65bd\u5065\u5eb7\u4e2d\u56fd\u6218\u7565\u5177\u6709\u6df1\u8fdc\u610f\u4e49\u3002\u5bf9\u7cd6\u5c3f\u75c5\u60a3\u8005\u8fdb\u884cASCVD\u5371\u9669\u5206\u5c42\uff0c\u9488\u5bf9\u4e0d\u540c\u5371\u9669\u5206\u5c42\u786e\u5b9a\u8840\u8102\u76ee\u6807\u503c\u548c\u964d\u8102\u6cbb\u7597\u65b9\u6848\u662f\u7cd6\u5c3f\u75c5\u60a3\u8005\u8840\u8102\u7ba1\u7406\u7684\u5173\u952e\u3002<\/p>\n

\u5728\u7cd6\u5c3f\u75c5\u60a3\u8005\u8840\u8102\u7ba1\u7406\u65b9\u9762\uff0c\u5c1a\u6709\u4e00\u4e9b\u4e9f\u5f85\u89e3\u51b3\u7684\u95ee\u9898\uff0c\u5305\u62ec\u964d\u8102\u6cbb\u7597\u9776\u6807\u3001\u65b0\u578b\u964d\u8102\u836f\u7269\u7684\u968f\u673a\u5bf9\u7167\u7814\u7a76\u3001\u7279\u6b8a\u4eba\u7fa4\uff08\u5982T1DM\u60a3\u8005\u3001\u8001\u5e74\u60a3\u8005\u3001\u513f\u7ae5\u548c\u9752\u5c11\u5e74\uff09\u7684\u964d\u8102\u6cbb\u7597\u65b9\u6848\u7b49\u3002\u672a\u6765\u8fd8\u9700\u5f00\u5c55\u66f4\u591a\u5305\u62ecT1DM\u548cT2DM\u60a3\u8005\u5728\u5185\u7684\u5927\u89c4\u6a21\u3001\u591a\u4e2d\u5fc3\u4e34\u5e8a\u7814\u7a76\uff0c\u4e3a\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684\u8840\u8102\u7ba1\u7406\u63d0\u4f9b\u66f4\u591a\u9ad8\u8d28\u91cf\u7684\u5faa\u8bc1\u4f9d\u636e\u3002<\/p>\n

\u7275\u5934\u4e13\u5bb6\uff1a<\/p>\n

\u5468\u667a\u5e7f \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u5f6d\u9053\u6cc9 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u6267\u7b14\u4e13\u5bb6\uff1a<\/p>\n

\u8096   \u626c \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u4e8e\u78a7\u83b2 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u7f16\u5199\u59d4\u5458\u4f1a\u6210\u5458\uff08\u6309\u8d21\u732e\u5927\u5c0f\u6392\u5e8f\uff09\uff1a<\/p>\n

\u8d85   \u6668 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u738b   \u5e05 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u80e1   \u8776 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u6b66   \u8d85 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u7f57\u6c38\u7ea2 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u8c22\u51cc\u7fd4 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u674e\u6668\u745c \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u4e13\u5bb6\u59d4\u5458\u4f1a\u6210\u5458\uff08\u6309\u59d3\u6c0f\u62fc\u97f3\u6392\u5e8f\uff09\uff1a<\/p>\n

\u6bd5\u5b87\u82b3 \u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u745e\u91d1\u533b\u9662<\/p>\n

\u535c   \u519b \u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u4ec1\u6d4e\u533b\u9662<\/p>\n

\u66fe\u6625\u96e8 \u9646\u519b\u519b\u533b\u5927\u5b66\u5927\u576a\u533b\u9662<\/p>\n

\u9648   \u7ea2 \u5317\u4eac\u5927\u5b66\u4eba\u6c11\u533b\u9662<\/p>\n

\u9648\u8389\u660e \u5929\u6d25\u533b\u79d1\u5927\u5b66\u6731\u5baa\u5f5d\u7eaa\u5ff5\u533b\u9662<\/p>\n

\u9648\u6862\u73a5 \u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u745e\u91d1\u533b\u9662<\/p>\n

\u7a0b   \u7fd4 \u534e\u4e2d\u79d1\u6280\u5927\u5b66\u540c\u6d4e\u533b\u5b66\u9662\u9644\u5c5e\u534f\u548c\u533b\u9662<\/p>\n

\u4e1b\u6d2a\u826f \u5929\u6d25\u5e02\u80f8\u79d1\u533b\u9662<\/p>\n

\u8463\u5401\u94a2 \u4e2d\u5c71\u5927\u5b66\u9644\u5c5e\u7b2c\u4e00\u533b\u9662<\/p>\n

\u7aa6\u514b\u975e \u4e2d\u56fd\u533b\u5b66\u79d1\u5b66\u9662\u961c\u5916\u533b\u9662<\/p>\n

\u90ed\u7acb\u65b0 \u5317<\/p>\n

\u90ed\u8fdc\u6797 \u4e2d\u56fd\u533b\u5b66\u79d1\u5b66\u9662\u961c\u5916\u533b\u9662<\/p>\n

\u8d3a\u6c38\u660e \u82cf\u5dde\u5927\u5b66\u9644\u5c5e\u7b2c\u4e00\u533b\u9662<\/p>\n

\u6d2a\u5929\u914d \u5317\u4eac\u5927\u5b66\u7b2c\u4e09\u533b\u9662<\/p>\n

\u59ec\u79cb\u548c \u897f\u5317\u5927\u5b66\u9644\u5c5e\u897f\u5b89\u56fd\u9645\u533b\u5b66\u4e2d\u5fc3\u533b\u9662 \u5185\u5206\u6ccc\u4ee3\u8c22\u75c5\u533b\u9662<\/p>\n

\u7eaa\u7acb\u519c \u5317\u4eac\u5927\u5b66\u4eba\u6c11\u533b\u9662<\/p>\n

\u91d1   \u840d \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e09\u533b\u9662<\/p>\n

\u5321\u6d2a\u5b87 \u54c8\u5c14\u6ee8\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u7b2c\u4e00\u533b\u9662<\/p>\n

\u674e\u5efa\u519b \u4e2d\u56fd\u533b\u5b66\u79d1\u5b66\u9662\u961c\u5916\u533b\u9662<\/p>\n

\u674e\u5efa\u5e73 \u5317\u4eac\u5927\u5b66\u7b2c\u4e00\u533b\u9662<\/p>\n

\u674e   \u971e \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u674e\u5c0f\u82f1 \u590d\u65e6\u5927\u5b66\u9644\u5c5e\u4e2d\u5c71\u533b\u9662<\/p>\n

\u674e   \u52c7 \u590d\u65e6\u5927\u5b66\u9644\u5c5e\u534e\u5c71\u533b\u9662<\/p>\n

\u6881   \u6625 \u4e0a\u6d77\u957f\u5f81\u533b\u9662<\/p>\n

\u5218   \u9759 \u7518\u8083\u7701\u4eba\u6c11\u533b\u9662<\/p>\n

\u5218   \u9759 \u9996\u90fd\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u5317\u4eac\u5b89\u8d1e\u533b\u9662<\/p>\n

\u5218   \u94ed \u5929\u6d25\u533b\u79d1\u5927\u5b66\u603b\u533b\u9662<\/p>\n

\u9646\u56fd\u5e73 \u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u745e\u91d1\u533b\u9662<\/p>\n

\u7f57\u6e58\u676d \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u533b\u9662<\/p>\n

\u6bcd\u4e49\u660e \u4e2d\u56fd\u4eba\u6c11\u89e3\u653e\u519b\u603b\u533b\u9662<\/p>\n

\u5f6d\u6c38\u5fb7 \u4e0a\u6d77\u5e02\u7b2c\u4e00\u4eba\u6c11\u533b\u9662<\/p>\n

\u5b8b\u6000\u4e1c \u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u7b2c\u4e5d\u4eba\u6c11\u533b\u9662<\/p>\n

\u82cf   \u9752 \u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u65b0\u534e\u533b\u9662<\/p>\n

\u5b59\u7231\u519b \u590d\u65e6\u5927\u5b66\u9644\u5c5e\u4e2d\u5c71\u533b\u9662<\/p>\n

\u5b59\u827a\u7ea2 \u4e2d\u65e5\u53cb\u597d\u533b\u9662<\/p>\n

\u5510\u71a0\u8fbe \u5317\u4eac\u5927\u5b66\u7b2c\u4e09\u533b\u9662<\/p>\n

\u6c6a   \u82b3 \u5317<\/p>\n

\u738b\u5efa\u5b89 \u6d59\u6c5f\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u7b2c\u4e8c\u533b\u9662<\/p>\n

\u7fc1\u5efa\u5e73 \u4e2d\u56fd\u79d1\u5b66\u6280\u672f\u5927\u5b66\u9644\u5c5e\u7b2c\u4e00\u533b\u9662<\/p>\n

\u5434\u5a1c\u743c \u4e2d\u56fd\u533b\u5b66\u79d1\u5b66\u9662\u961c\u5916\u533b\u9662<\/p>\n

\u8096\u6d77\u9e4f \u4e2d\u5c71\u5927\u5b66\u9644\u5c5e\u7b2c\u4e00\u533b\u9662<\/p>\n

\u4e25   \u52b1 \u4e2d\u5c71\u5927\u5b66\u5b59\u9038\u4ed9\u7eaa\u5ff5\u533b\u9662<\/p>\n

\u4e25\u6653\u4f1f \u5317\u4eac\u534f\u548c\u533b\u9662<\/p>\n

\u53f6   \u5e73 \u4e2d\u56fd\u4eba\u6c11\u89e3\u653e\u519b\u603b\u533b\u9662<\/p>\n

\u4f59\u5b66\u5cf0 \u534e\u4e2d\u79d1\u6280\u5927\u5b66\u540c\u6d4e\u533b\u5b66\u9662\u9644\u5c5e\u540c\u6d4e\u533b\u9662<\/p>\n

\u8881\u7956\u8d3b \u897f\u5b89\u4ea4\u901a\u5927\u5b66\u7b2c\u4e00\u9644\u5c5e\u533b\u9662<\/p>\n

\u5f20\u745e\u5ca9 \u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u745e\u91d1\u533b\u9662<\/p>\n

\u8d75   \u51ac \u9996\u90fd\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u5317\u4eac\u5b89\u8d1e\u533b\u9662<\/p>\n

\u8d75\u5bb6\u519b \u5c71\u4e1c\u7701\u7acb\u533b\u9662<\/p>\n

\u8d75\u6c34\u5e73 \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u90d1\u5b8f\u5ead \u9646\u519b\u519b\u533b\u5927\u5b66\u65b0\u6865\u533b\u9662<\/p>\n

\u5468\u80dc\u534e \u4e2d\u5357\u5927\u5b66\u6e58\u96c5\u4e8c\u533b\u9662<\/p>\n

\u6731\u5927\u9f99 \u5357\u4eac\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u9f13\u697c\u533b\u9662<\/p>\n

\u6731\u5efa\u534e \u6d59\u6c5f\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u7b2c\u4e00\u533b\u9662<\/p>\n

\u795d   \u70e8 \u56db\u5ddd\u5927\u5b66\u534e\u897f\u533b\u9662<\/p>\n

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