2022台灣血脂治療指引(英文版)下面中文使用google自動翻譯
LDL-C 目標值：高風險族群（糖尿病、慢性腎臟病、LDL-C ≥ 190 mg/dL）：
對於患有糖尿病、非透析慢性腎臟病或 LDL-C ≥ 190 mg/dL 的受試者，本指南建議 LDL-C 水平達到 100 mg/dL 時開始治療。由於 ASCVD 風險較高，應立即開始降血脂治療並進行生活方式介入。目前尚無僅針對 LDL-C ≥ 190 mg/dL 受試者的他汀類藥物治療的隨機、安慰劑對照試驗。 WOSCOPS 試驗是一項針對高膽固醇血症（平均 LDL-C 水平為 192±17 mg/dL）且無血管疾病史的受試者進行的普伐他汀（40 mg/天）隨機、安慰劑對照試驗。 <sup>38</sup> 普伐他汀的使用顯著降低了心肌梗塞和心血管死亡的發生率。 WOSCOPS試驗中2560名基線LDL-C水平為190 mg/dL的受試者的事後分析顯示，他汀類藥物治療在試驗初期和超過20年的隨訪期內均顯著降低了主要不良心血管事件（MACE）的風險。 <sup>32</sup> 由於ASCVD風險較高，LDL-C水平為190 mg/dL的受試者的治療目標為LDL-C <100 mg/dL。鑑於基線LDL-C水平較高，建議LDL-C水平為190 mg/dL的受試者使用中高強度他汀類藥物合併依折麥布治療。
建議：對於患有糖尿病、非透析慢性腎臟病且低密度脂蛋白膽固醇（LDL-C）≥190 mg/dL 的患者，應立即開始降血脂治療，LDL-C 目標值為 <100 mg/dL。 （證據等級 I，證據等級 B）對於 LDL-C ≥190 mg/dL 的患者，建議使用中高強度他汀類藥物合併依折麥布。 （證據等級 I，證據等級 B）
LDL-C target High risk (DM, CKD, LDL-C ‡ 190 mg/dL) For subjects with DM, non-dialysis CKD, or LDL-C ‡190 mg/ dL, this guideline suggests the LDL-C level for initiation of therapy and treatment target is 100 mg/dL. Because the ASCVD risk is high, lipid lowering therapy should be started immediately with lifestyle modification. There has been no randomized, placebo-controlled trial of statin therapy performed only in subjects with LDL-C 190 mg/dL. The WOSCOPS trial was a randomized placebo-controlled trial of pravastatin (40 mg/day) for subjects with hypercholesterolemia (mean LDL-C level of 192 17 mg/ dL) and without history of vascular disease.38 The use of pravastatin significantly reduced the incidence of MI and CV mortality. The post hoc analyses among the 2560 subjects in the WOSCOPS trial with baseline LDL-C 190 mg/dL showed that statin therapy significantly reduced the risk of major adverse cardiovascular events (MACE) in the initial trial phase and over 20 years of follow-up.32 Because of the high risk for ASCVD, the treatment target of LDL-C is <100 mg/ dL in subjects with LDL-C 190 mg/dL. Since the baseline LDL-C level is high, moderate-to high-intensity statins combined with ezetimibe is recommended for subjects with LDL-C 190 mg/dL
Recommendation In subjects with DM, non-dialysis CKD, LDL-C 190 mg/dL, immediate lipid lowering therapy should be started and the LDL-C target is <100 mg/ dL. (COR I, LOE B) In subjects with LDL-C 190 mg/dL, moderate-to high-intensity statins combined with ezetimibe is recommended. (COR I, LOE B)
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