(2) The diet structure is adjusted to "four lows and one high" with low calorie, low cholesterol, low fat, low sugar and high cellulose.
The diet structure is the most reasonable.
① Control the total calorie intake. Especially overweight or obese people, they should lose weight and reach the standard weight range. The suitable speed of losing weight is 0.5 ~ 1 kg per week.
The limitation of calorie intake should be considered comprehensively according to the patient's age, work nature, activity ability and accompanying diseases. The average 60-year-old person has 1600 ~ 2000 kcal (6688 ~ 8360 kJ) per day.
② Diet therapy is divided into two steps. The first step is to distribute the total calorie intake every day. Sugar accounts for 50% ~ 60%, protein accounts for 10% ~ 20%, and fat accounts for 30%, including saturated fatty acids (such as fat meat, full-fat dairy products, egg yolk, hairtail, butter and animal viscera including brain, liver, heart, kidney and intestine), monovalent unsaturated fatty acids and multivalent unsaturated fatty acids.
If the first step can't achieve the expected goal, the second step of diet therapy should be implemented, which requires 20% fat, 7% saturated fatty acids and cholesterol every day.
Avoid too many sweets, sweet drinks, sweets, etc. In daily diet, obese people pay more attention.
④ The content of cellulose in daily food is >; 35g contains more cellulose, such as bean products, oats, vegetables, fruits and coarse grains.
⑤ Patients with chyluremia should eat fatty foods containing medium-chain fatty acids instead of long-chain fatty acids.
(3) Strengthening physical activity, physical labor and physical exercise can not only lose weight and regulate abnormal blood lipids in the body, but also reduce serum triglycerides and cholesterol, increase high-density lipoprotein, lower blood pressure and reduce the risk of diabetes. Precautions during exercise are as follows.
(1) Have a comprehensive physical examination before exercise, and make an estimate of your physical condition so that you can exercise under the guidance of a doctor.
② Exercise should be done step by step, according to your original activity.
③ Exercise at the right time, and keep exercising every day 1 hour.
Moderate exercise, no fatigue during the activity, slight sweating, feeling relaxed after the activity, and good appetite.
The types of activities should be based on their original activities, such as walking, climbing stairs, jogging, mountaineering, kicking shuttlecock, dancing, playing table tennis and so on.
6. Exercise must persist.
(4) Drug treatment ① When the dyslipidemia still can't reach the ideal level after 3 to 6 months of diet therapy and moderate exercise, those who have coronary heart disease or other arteriosclerosis diseases, those who have no coronary heart disease but have two or more risk factors for coronary heart disease, or those who have undergone coronary angioplasty or coronary artery bypass grafting should consider applying lipid-lowering drugs.
The main functions of lipid regulators are: to prevent intestinal absorption of lipid or cholic acid and promote excretion; Inhibit the synthesis of lipids in vivo or accelerate the degradation and metabolism; Enhance the activity of related enzymes or receptors in lipid metabolism.
② At present, there are five kinds of blood lipid regulators used in clinic. Bile acid chelating agent, sphingosine, sphingosine; Nicotinic acid, nicotinic acid, inositol nicotinate, acipimox; Phenoxy aromatic acid, bezafibrate, gemfibrozil, fenofibrate, ciprofibrate, Yiduo ester and clofibrate; Probkau; 3- carboxy -3- methylglutaryl coenzyme A reductase inhibitors (statins), lovastatin, simvastatin, pravastatin, fluvastatin.
(5) At present, there is no specific drug for treating homozygous familial cholesterolemia. After portal vein anastomosis, plasma purification therapy or gene transfer therapy, cholesterol-lowering drugs can be taken first, which can reduce serum cholesterol level.