2025台灣血脂管理臨床路徑共識

2025 Consensus on Clinical Pathway of Blood Cholesterol Management in Taiwan

李貽恒(Yi-Heng Li) ； 石崇良(Chung-Liang Shih)

《內科學誌》 35卷6期 (2024/12) Pp. 426-430

https://doi.org/10.6314/JIMT.202412_35(6).04

摘要

低密度脂蛋白膽固醇（LDL-C）升高是動脈粥狀硬化心血管疾病（atherosclerotic cardiovascular disease, ASCVD）最重要的風險因子之一。然而，現行的LDL-C建議治療目標，在台灣的達成率不盡理想，仍有相當大的改善空間。血脂管理臨床路徑是根據台灣血脂治療指引和台灣主要醫學會的專家建議所制定，其目的在改善暴露於ASCVD風險或已確診為ASCVD族群的預後，這些對象可以從血脂控制中獲得臨床效益，以減少新發或復發的心血管事件風險。本臨床路徑為不同ASCVD風險族群設定合理的LDL-C治療目標，並標準化有關後續血脂管理和追蹤的模式，其最終目的是促進達成個別LDL-C治療目標，確保病人得到適當的監測，並優化合適的血脂治療以降低ASCVD風險。

關鍵字

低密度脂蛋白膽固醇（low-density lipoprotein cholesterol） ； 動脈粥狀硬化心血管疾病（atherosclerotic cardiovascular disease） ； 臨床路徑（clinical pathway）

並列摘要

Elevated low-density lipoprotein cholesterol (LDL-C) is a significant risk factor of atherosclerotic cardiovascular disease (ASCVD). However, the current recommended treatment targets for LDL-C in Taiwan have not been met, indicating a substantial room for improvement. This lipid management clinical pathway is developed based on Taiwan lipid guidelines and expert recommendations from nine major medical societies in Taiwan. Its aim is to improve the prognosis of individuals exposed to ASCVD risk or those already diagnosed with ASCVD, as these populations can benefit from lipid control to reduce the risk of new or recurrent cardiovascular events. This clinical pathway sets reasonable LDL-C treatment targets for different ASCVD risk groups and standardizes the subsequent lipid management and follow-up models. The ultimate goal is to facilitate the achievement of individual LDL-C targets, ensure patients receive appropriate monitoring, and optimize suitable lipid therapy to reduce the risk of ASCVD.