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各位朋友大家好，现在是“每天健康三分钟”时间。我是道简-心血管康复医生集团的医生黄喜梅，今天主要给大家讲的是：血脂不高，为什么要吃降脂药呢？
有时候去医院检查，血脂化验结果都在正常范围内，但医生仍建议服药，实在想不通是为什么?
血脂包括多项参数，比如总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯等。其中，最重要也是医生关注最多的是低密度脂蛋白胆固醇。因为，低密度脂蛋白胆固醇水平越高，越容易发生冠心病、心肌梗死、脑梗塞等病。
临床上也经常有患者问：“我血脂不高为什么还让我吃降脂药?”“我的甘油三酯升高了，医生为什么不给我开降脂药?”首先要说明一个问题。
虽然很多医院的血脂化验单上注明了各项血脂指标的正常值范围，但是否需要应用降脂药物，并不能完全依据此指标范围，而需要结合患者具体情况而定。所以，患者不要因为化验单中各项血脂参数均在正常范围内就认为“血脂正常”，也不要因为一些指标低于“正常值”而自行停药。拿到血脂化验单后一定要找医生咨询，由医生确定是否需要用药。
动脉粥样硬化斑块是导致冠心病、心梗和脑梗的主要诱因，而胆固醇是形成动脉斑块的原料。胆固醇越高，越容易形成斑块。但不同人相对安全的胆固醇水平不同，如果某人较年轻、不吸烟、不肥胖、父母没有心血管病、没有高血压和糖尿病，未来发生心脑血管疾病的风险较小，其低密度脂蛋白胆固醇只要不超过3.4毫摩尔/升即可。
若患者已发生冠心病，或同时患有高血压与糖尿病，低密度脂蛋白胆固醇超过1.8毫摩尔/升就要治疗;糖尿病患者这一指标不应超过2.6毫摩尔/升。而确诊冠心病与脑梗的患者，无论胆固醇化验结果如何，均应服用他汀类降脂药。
甘油三酯也是重要的血脂参数。
多数医院的化验单中均将该指标的正常值设定为1.7毫摩尔/升以下。但超过这一数值并不意味着需要药物治疗。如果甘油三酯不超过2.26毫摩尔/升，一般无需服用降脂药，通过合理饮食、增加运动、减轻体重、限制饮酒等，指标完全可以恢复正常，只有指标明显升高时才考虑药物治疗。
最后祝大家生活愉快，身体健康！想要了解更多心血管科普知识请关注我们，咱们下期见。
【英文版】
Why should we take lipid lowering drugs when blood lipid is not high?
Dear friends, nice to meet you!Now it is time for “Health talk for three minutes every day”,My name is Huang Ximei, a doctor of Daojian Doctor Group of Cardiovascular Rehabilitation.Today, I will mainly introduce “ Why should we take lipid lowering drugs when blood lipid is not high?”
Sometimes people go to the hospital for a check up, blood lipid test results are all in the normal range,why doctors still suggest taking medicine?As blood lipids include a number of parameters, such as total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides, etc.Among them, the most important and the one that doctors pay most attention to is LDL cholesterol.As the higher the level of LDL-C, the more prone the patients to coronary heart disease, myocardial infarction, cerebral infarction and other diseases.Clinically, patients often ask, My blood lipids are not high, why I still need to take lipid-lowering medicine ? My triglycerides have gone up, why don't the doctor prescribe lipid-lowering drugs ?
First, there is a question that needs to be explained.Although blood lipid test sheet in many hospital indicate the normal value range of each blood lipid index, However, it can not be completely based on this index range whether the patients need to apply lipid-lowering medicine or not, the doctor needs to combine the patient's specific situation to decide.Therefore, patients should not assume that blood lipids are normal just because all the lipid parameters in the test sheet are in the normal range.and don't stop taking medication just because some indexes are below "normal value".You should consult a doctor after getting the blood lipid test sheet,and the doctor will determine whether the medication is needed or not.
