关键词: 高脂血症, 混合性高脂血症, 社区卫生服务, 干预性研究, 治疗结果

Abstract: Background　Combined hyperlipidemia is the most common type of abnormal lipoprotein metabolism or transport in the general population with dyslipidemia in China.A series of clinical studies at home and abroad have confirmed that mixed hyperlipidemia is an important cause of atherosclerotic cardiovascular disease（ASCVD），such as coronary heart disease，stroke and peripheral vascular disease.To prevent and control chronic disease at primary care level，it is essential for community general practitioners（GPs） to conduct comprehensive interventions including lifestyle intervention and medication selection according to related guidelines.Objective　To explore the effects of community-based interventions in mixed hyperlipidemia.Methods　329 eligible patients with mixed hyperlipidemia were recruited from Fangshan Community Health Center during March 2014 to September 2018，including healthcare seekers and physical examinees，as well as downward referrals from specialty hospitals.They were divided into low-to-medium risk group（n=204），high risk group（n=93） and extremely high risk group（n=32） by the baseline plasma lipid level according to the criteria defined in Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults（2016 Revision）.All participants received multiple comprehensive interventions from community GPs，such as diet regulation，appropriate exercise，drug treatment，health education and so on.The patients were followed up for 12 months to observe the improvement of adherence to treatment，plasma lipid indices（TC，LDL-C，HDL-C，and TG） and BMI.Results　The adherence to treatment in all participants after intervention was better than before（Z=256.206，P<0.05）.The mean levels of post-intervention TC，LDL-C and TG were all lower than the baseline levels（P<0.05）.However，there was no significant difference between mean pre-and post-intervention HDL-C levels（P>0.05）.The mean BMI in extremely high risk，high risk and low-to-medium risk groups after intervention improved significantly after intervention（Z=30.019，230.882 and 184.877，respectively，P<0.01）.Conclusion　Through comprehensive interventions，such as community health education，scientific lifestyle intervention and rational selection of lipid-lowering drug treatment，the adherence to treatment，plasma lipid indices and BMI in people with mixed hyperlipidemia were effectively improved.The interventions are worthy of community promotion.

Key words: Hyperlipidemias, Mixed hyperlipidemia, Community health services, Intervention studies, Treatment outcome