家族性高胆固醇血症:早期心血管并发症、治疗难题和延迟诊断的致命后果:深入病例研究

Mina Boutgourine, Hafssa Rouam, M. E. Jamili, M. Hattaoui
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摘要

家族性高胆固醇血症(FH)是最常见的遗传疾病之一,从出生时就存在。其遗传方式主要为常染色体显性遗传。其特征是低密度脂蛋白(LDL)的独家增加。它与过早出现心血管并发症的高风险有关。FH 的诊断一般基于临床表现或基因检测。常用的标准是荷兰血脂诊所网络的标准。高血脂症是一种遗传性疾病,在很大程度上仍未得到充分诊断和治疗。该病的预后与动脉粥样硬化性心血管并发症有关,在缺乏治疗的情况下,这些并发症会导致患者在头三十年内死亡,通常是由于心肌梗死或猝死。家族性高胆固醇血症的治疗主要包括两类措施:一类是所谓的卫生饮食措施,如果存在其他危险因素,则与治疗这些因素相关;另一类是药物治疗。家族性高胆固醇血症的发现率仍然很低。有必要制定系统的方法来识别家族性高胆固醇血症患者,对其亲属进行逐级筛查,并提高对家族性高胆固醇血症的认识和控制。
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Hypercholesterolemia Familial: Early Cardiovascular Complications, Treatment Challenges, and the Fatal Consequences of Delayed Diagnosis: an in-Depth Case Study
Familial Hypercholesterolemia (FH) is among the most common genetic disorders, present from birth. The transmission is mainly autosomal dominant. It is characterized by a exclusive increase in low-density lipoproteins (LDL). It is associated with a high risk of premature cardiovascular complications. The diagnosis of FH is generally based on the clinical presentation or genetic tests. The commonly used criteria are those of the Dutch Lipid Clinic Network. FH is a hereditary condition still largely underdiagnosed and undertreated. The prognosis of the disease is related to atheromatous cardiovascular complications, which, in the absence of treatment, lead to the patient's death in the first three decades, often due to myocardial infarction or sudden death. The management of familial hypercholesterolemia systematically involves two categories of measures: so-called hygienic-dietary measures associated with the treatment of other risk factors when they exist, and drug treatments. Familial hypercholesterolemia is still poorly detected. It is necessary to develop systematic approaches to identify patients with FH, conduct cascade screening of their relatives, and increase awareness and control of FH.
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