国际动脉粥样硬化学会预防动脉粥样硬化性心血管疾病综合指南

12020/IASIASIAS2/NCEPIIIATPIII,NCEP20013NCEPATPIII-Meta,,N-9N-64N-3N-9N-9N-9N-3/BMIkg/m2BMIBMIkg/m2BMIkg/m218.518.518.5-24.918.5-22.925-29.923-24.93030-34.935.0-39.9402525-29.930/5102cm40in90cm85cm88cm35in80cm90cm61/36LDLLDLLDLLDLHDLLDLLDL7LDLLDLHDLHDLHDLHDLHDL-CHDLHDLHDLHDLHDLHDLHDLHDLHDLLDLHDL-CHDL-CHDL-C126mg/dl7.0mmol/l12128ATPCHDCVDCHD1CHD22ATPCVDCVDCVDCHDCVDCVD12CVDCHD9LDL-C2-12(a)PROCAM10-1510LDLHDL(a)BCAIMetaLDLHDL(a)(a)LDLLp(a)LDLLp(a)B(apoB)LDLTGRLPapoBLDL-CapoBHDL-CTCHDL-CLDLHDL-CATPIIIHDL-CLDL-CCIII(apoCIII)HDL-CAI(apoAI)11-1(PAI-1)D-PAI-1D-V(tPA)vWVLeidenCIIIPAI-1AntithromboticTrialistsCollaboration28713500077000Meta1/41/31/41/6C-(hs-CRP)-61(sICAM-1)E-P-hs-CRPhs-CRP12hs-CRPHMG-CoA(statin)PPARPPARTZDS/,110-125mg/dl2/()2PROCAMMONICAARIC/13TCHDL-CTC/HDL-CTC/HDL-CTC/HDL-C5TC/HDL-CTCHDL-CXATPIII●--LDL-HDL●●●●ATPATPIII●*●150mg/dl1.69mmol/l●HDL-C-40mg/dl1.0mmol/l-50mg/dl1.3mmol/l●-130mmHg1485mmHg●110mg/dl6.0mol/l*102cm40in90cm85cm88cm35in80cm90cmWHOATPIIIATPCVD22021040ATPIIICHD15CHDCHDCHD20%CHDCHD●●●●ABI0.9●●TIAs501020CHD1020a.bFraminghamPROCAM16ATPIIICHD1012CHD1997CHDCHD30CHD,HDLCATPCHDPROCAMWestphaliaPROCAM35389356510325PROCAMLDLCHDLCCHDPROCAMCHD()PROCAMPROCAMCHDCVD1722ATPCHD1020ATPCHDCHDCVDPROCAMCHD1020CVDCHDPROCAMCHDCHD2CHDCHDCVDCHDCHDCHDCHDCHD10201020CHDCVDCVD18ATPCHDATPIIIIASATPIIICHD20/10,1020/10LDLC130mg/dl(2.6mmol/l)CHD1010QALY50000OALY50000600101020LDLC130mg/dl19ATPCHDCHD1010LDLCLDLC160mg/dl2CHDCHDATPCVDCHDPROCAMCVD1020CVDCHD1CVDCVD10LDLC190mg/dl4.9mmol/l130kgm2IASCHO1020%21LDL-ATPNCEP20017%200mg/LDL-CATP●/2g/●10g/LDL22●5●●400-1000mg●N-31%--N-31g/●20-30g10-20g100mmol2.461-230-4590mmol//●●●●10%●10%●●●●10%500-1000kcal●23/330545●/●●303-4U.S.SurgeonGeneral's●●24●●●●a/bc●aSRbcdeab●//130/85mmHg25/130-139/85-89mmHg19994-LDL-CLDLHMGALDL-C30%1/3LDL-CNCEPLDL-C100mg/dL2.6mmol/LLDL-C3.0mmol/L115mg/dLLDL-CLDL-CLDLLDL-C100mg/dL2.6mmol/L100mg/dLLDL-CATPLDL●LDL-CLDL●LDL-C30%●LDL-C100mg/dl(2.6mmol/L)LDL-C100mg/dl(2.6mmol/L)LDL26LDL-CLDLLDL-CHDL-CHDLLDLLDL-CHDLHDLHDLHDLATPHDL-CHDL75-325mg75mg/2.0-3.07%LDLJNC130/85mmHg130/80mmHgATPLDL-C100mg/dl(2.6mmol/L)CHD1020%PROCAM20%ATP27CHDATP1010-20%20%1010-20%1020%PROCAMATPCHDCHD(1010-20%)(KillipII)--CHD1020%CHD1020%28IASCHD1020%CHD105-20%//10%/29/3030-603-660-75%5-10308-1010-1510-1540%-50%30JNCCHD1020%●130-139/85-89mmHg●1140-159/90-99mmHg●2/3160/100mmHgJNCJNC140/90mmHg100mmol1230-4590mmolJNC---JNCLDL-CLDL1020%LDL-C311020%LDL5ATP1020%LDL20-1ATP21020%10LDL-C●2101020LDL-C130mg/dl3.4mmol/lLDL-C130mg/dl33LDL-C130mg/dlLDLLDL-C130mg/dlLDLLDL130mg/dl65●21010LDL-C130mg/dlLDL-C130mg/dlLDL-CLDL-C160mg/dl4.1mmol/lLDLLDL-Cl60mg/dlLDL-C130mg/dl0-1LDL-C160mg/dl3LDL-C160mg/dlLDL-C160-189mg/dl4.1-4.9mmol/l●CHD32HDL-C●●1010%LDL-C190mg/dl4.9mmol/lLDL-C160mg/dl0-1LDL-C160mg/dlLDLLDL-C190mg/dl4.9mmol/lLDL-CLDL-C1020%CHDHDL-CHDLIASATPHDL-CHDLHDL-CLDL-CLDL-CLDLHDL-C200-499mg/dl2.24-5.63mmol/lHDL-C200mg/dl2.24mmol/lHDL-CHDLCHDCHD33Lp(a)34LDL-C190mg/dl4.9mmol/lLDL-CBCHD+LDLMetaCHD60%2AATPz150mg/dL(1.69mmol/L)z150-199mg/dL(1.69-2.24mmol/L)z200-499mg/dL(2.24-5.63mmol/L)z500mg/dL(5.63mmol/L)CHDVLDLVLDL-CVLDL-CATPLDL-CVLDL-CHDL-CTCHDL-C200mg/dl2.24mmol/lHDL-C30mg/dl0.8mmol/lLDL-CVLDL-C30mg/dl0.8mmol/lLDL-C100mg/dl(2.6mmol/L)HDL-C130mg/dl(3.4mmol/L)35LDL-C150-199mg/dl1.69-2.24mmol/lATP200-499mg/dl2.24-5.63mmol/lHDL-CLDL-CHDL-CVLDL-CHDL-CHDL-C500mg/dl5.63mmol/l15%500mg/dl(5.63mmol/L)LDLCHD2LDLHDL-C/HDL-CLDL-CATPCHDLDL-C100mg/dl(2.6mol.L)ATPLDL-C130mg/dl3.4mmol/lLDL-CLDL-C100-129mg/dl2.6-3.4mmol/lLDLLDL-C100-129mg/dlLDLCHD653635-65CHDCHDCHDLDL45-75CHD10-15CHD65CHD65CHDCHDCHD10LDL-CCHDLDL-C6575CHD65LDL-CHDL-CCHD65CHDLDLLDLLDL37CHDCVDCVDCVD20-3520-45CHDCHDCHDLDL-CLDL-C130mg/dl3.4mmol/lLDL-C160-189mg/dl4.2-5.0mmol/mATPLDLLDL-C190mg/dl5.0mmol/lCVD/38/CVD/CVDHDL-CCHDIASCVD/39CVDCVDCVDIASCHDJCNIAS61-611020-34-940-44050-54660-641070-741235-39-445-49355-59865-691175-791320-3940-4950-5960-6970-7916000000160-19943210200-23975310240-24996421280+11853120-3940-4950-5960-6970-79000008531140HDLHDLHDLHDL60+-150-59040-49140212000120-12901130-13912140-15912160+2310101001%52%118%01%62%1210%11%73%1212%21%84%1416%31%95%1520%41%106%1625%17304121020-34-740-44050-54660-641070-741435-39-345-49355-59865-691275-791620-3940-4950-5960-6970-7916000000160-19943211200-23986421240-279118532280+131074220-3940-4950-5960-6970-790000097421HDLHDLHDLHDL60+-150-59040-49140212000120-12913130-13924140-15935160+4610101091%142%2011%91%153%2114%42101%164%2217%111%175%2322%121%186%2427%132%198%2530%43310PROCAM35-39040-44645-491150-541655-592160-6526LDL-Cmg/dlLDL-Cmmol/l1002.590100--1292.59---3.365130--1593.37-4.1310160-1894.14-4.91141904.9220HDL-Cmg/dlmmol/lTGmg/dlmmol/l350.91111001.14035-440.91-1.168100-1491.14-1.70245-541.17-1.415150-1991.71-2.273551.4202002.28412120mg/dl(6.66mmol/l)(60)864000441200120-1292130-1393140-15951608PROCAM:10101010101010201.0271.8343.5417.04812.85522.2211.1281.9354.0427.44913.25623.8221.2292.3364.2438.05015.55725.1231.3302.4374.8448.85116.8582