卫生部办公厅关于印发《血脂异常与心肌梗死和脑血栓防治知识宣传要点》的通知
卫生部办公厅
卫生部办公厅关于印发《血脂异常与心肌梗死和脑血栓防治知识宣传要点》的通知
各省、自治区、直辖市卫生厅局，新疆生产建设兵团卫生局：
目前我国约有1.6亿人患血脂异常，成人血脂异常总患病率为18.6%。血脂异常是心肌梗死和脑血栓的重要危险因素，严重危害我国城乡居民的健康。为指导血脂异常的宣传教育工作，为公众和媒体提供正确的血脂异常相关知识和信息，我部组织专家编写了《血脂异常与心肌梗死和脑血栓防治知识宣传要点》。现印发你们，为各地开展血脂异常防治宣传工作，普及血脂异常预防知识，动员全社会共同参与，降低血脂异常发病率提供参考。
二○○八年四月一日
血脂异常与心肌梗死和脑血栓防治知识
宣传要点
一、基本知识
（一）我国每年死亡人数中约有40％死于心血管疾病。
（二）我国心血管病以缺血性（包括冠心病和脑血栓）为主，其病理基础是动脉粥样硬化。血脂异常是引发这些疾病的主要危险因素之一。
（三）血脂包含胆固醇、甘油三酯、类脂等不同成分。其中，胆固醇包括低密度脂蛋白胆固醇和高密度脂蛋白胆固醇。
（四）低密度脂蛋白胆固醇升高是心肌梗死的“元凶”，脑血栓的“帮凶”。
（五）当前，血脂异常的首要治疗目标是降低低密度脂蛋白胆固醇。
（六）重点人群（40岁以上男性、绝经女性、肥胖者、有黄色瘤、有血脂异常及心脑血管病家族史者）在有条件的情况下，应每年检测一次血脂。
（七）合理饮食和规律运动不仅是预防血脂异常的根本手段，而且是治疗血脂异常的基础。
（八）他汀类药物是降低胆固醇，预防心肌梗死和脑血栓的最有效药物。
（九）降胆固醇治疗要长期坚持。
二、基本知识要点
（一）我国每年死亡人数中约有40％死于心血管疾病。
Ø 2005年卫生部公布的资料显示：全国每年约有300万人死于心血管疾病，每天约8000人，约合每10秒钟1人。每年新发心肌梗死和脑血栓患者数分别为50万和200万。
（二）我国心血管病以缺血性（包括冠心病和脑血栓）为主，其病理基础是动脉粥样硬化。血脂异常是引发这些疾病的主要危险因素之一。
Ø 缺血性心血管病（包括冠心病和脑血栓）的病理基础是动脉粥样硬化。引发动脉粥样硬化的危险因素包括高胆固醇、高血压、糖尿病、吸烟等，尤其是以往重视不够的高胆固醇。
（三）血脂包含胆固醇、甘油三酯、类脂等不同成分。其中，胆固醇包括低密度脂蛋白胆固醇和高密度脂蛋白胆固醇。
Ø 血脂是血浆中脂类的统称，包含胆固醇、甘油三酯以及磷脂等类脂。
Ø 胆固醇包括低密度脂蛋白胆固醇（俗称“坏”胆固醇）和高密度脂蛋白胆固醇（俗称“好”胆固醇）。低密度脂蛋白胆固醇升高危害最大，是导致动脉粥样硬化的基本条件。
Ø 低密度脂蛋白胆固醇会在血管里形成动脉粥样硬化斑块。斑块不断增大，使动脉逐渐狭窄甚至阻塞，引起心绞痛、心肌缺血、脑梗死、脑软化。这些斑块就像“不定时炸弹”，会在没有任何先兆的情况下破裂，迅速堵塞血管，引发急性心肌梗死甚至猝死。
Ø 以北京市为例，1984-1999年间成年人胆固醇水平增加了40mg/dL，而在此期间由胆固醇升高引起的冠心病死亡数增加了77%。
（四）低密度脂蛋白胆固醇升高是心肌梗死的“元凶”，脑血栓的“帮凶”。
Ø 从20世纪60年代开始，大量临床研究表明，胆固醇每降低1％，冠心病的发生率就会降低2％，被称为1=2公式。
Ø 大量临床研究表明，冠心病、糖尿病、高血压患者的低密度脂蛋白胆固醇每降低10%，脑血栓的发生率就会减少15.6%。
（五）当前，血脂异常的首要治疗目标是降低低密度脂蛋白胆固醇。
Ø 治疗血脂异常是为了防治冠心病，尤其是心肌梗死和猝死，而低密度脂蛋白胆固醇与发生心肌梗死的关系最密切，因此血脂异常的首要治疗目标是将低密度脂蛋白胆固醇降低至达标。
Ø 急性心肌梗死、不稳定心绞痛、冠心病或脑血栓+糖尿病患者属于极高危人群，在未来10年发生心肌梗死的概率为30－50％。低密度脂蛋白胆固醇应降到<2.1mmol/L (80mg/dL)。
Ø 糖尿病、脑血栓、高血压+3个危险因素患者属于高危人群，在未来10年发生心肌梗死的概率为14－16％。低密度脂蛋白胆固醇应降到<2.6mmol/L (100mg/dL)。
Ø 高血压+任何1个其他危险因素：低密度脂蛋白胆固醇应降到<3.4mmol/L（130mg/dL）。
Ø 无以上疾病或危险因素的血脂异常患者：低密度脂蛋白胆固醇应降到<4.1mmol/L (160mg/dL)。
Ø 单纯轻-中度甘油三酯升高的患者，首选减轻体重及增加体力活动；中度升高患者（>200mg/dL）可加用降甘油三酯药物；如果甘油三酯水平超过500mg/dL，应特别关注，以预防急性胰腺炎。
（六）重点人群（40岁以上男性、绝经女性、肥胖者、有黄色瘤、有血脂异常及心脑血管病家族史者）在有条件的情况下，应每年检测一次血脂。
这些人或者已经患有血脂异常，或者是血脂异常的易患人群，因此需要定期检测血脂，以便及时发现血脂异常情况，及早干预。
（七）合理饮食和规律运动不仅是预防血脂异常的根本手段，而且是治疗血脂异常的基础。
Ø 单纯饮食控制和运动可使胆固醇降低7-9%。
Ø 即使正在服用降胆固醇药物，也应坚持健康饮食和规律运动。
Ø 血脂异常防治饮食指南：
l 控制总热量：主食每天4两（女）、6两（男），以全麦面包、燕麦、糙米、土豆、南瓜为佳，少吃点心，不吃油炸食品。
l 减少饱和脂肪酸的摄入：少吃肥肉，每天每人烹调用油<25克。
l 增加不饱和脂肪酸的摄入：每周吃2次鱼，用橄榄油或茶籽油代替其他烹调用油。
l 控制胆固醇的摄入：不吃动物内脏，蛋黄每周不超过2个，建议用脱脂奶代替全脂奶。
l 每天吃蔬菜1斤、水果1-2个，适量豆制品。
Ø 规律运动一三五七：
l 一：每天锻炼一次；
l 三：每次至少30分钟；
l 五：每周至少运动五次；
l 七：运动时心率=170-年龄。
Ø 健康生活方式12字诀：不吸烟，管好嘴，迈开腿，好心情。
（八）他汀类药物是降低胆固醇，防治心肌梗死和脑血栓最有效的药物。
Ø 他汀类药物能显著降低低密度脂蛋白胆固醇，同时也降低甘油三酯和轻度升高高密度脂蛋白胆固醇；此外，他汀类还可能具有抗炎、保护血管内皮功能等作用。近20年的临床研究显示，他汀类药物是降低胆固醇，预防心肌梗死和脑血栓最有效的药物。
Ø 冠心病患者（包括心肌梗死、心绞痛、装过支架、做过搭桥手术的患者）服用他汀类药物3-5年，可减少30-40%心肌梗死的再发和20-30%偏瘫的发生,减少30%的死亡。
Ø 糖尿病患者服用他汀类药物3-5年，可预防30-40%心肌梗死和偏瘫的发生。
Ø 高血压患者服用他汀类药物3-5年，可预防30-40%心肌梗死和20-30%偏瘫的发生。
（九）降胆固醇治疗要长期坚持。
Ø 血脂异常是慢性疾病，其导致动脉粥样硬化和冠心病的影响持续存在，且逐步加重。大量研究证明，降胆固醇治疗时间越长，预防心肌梗死的益处越大，所以应长期坚持。
Ø 与治疗高血压、糖尿病一样，一旦停药，降胆固醇药物对体内血脂代谢异常的治疗作用就会消失，低密度脂蛋白胆固醇就会再次升高，所以应坚持长期服用降胆固醇药物。
Ø 他汀是安全高效的降胆固醇药物，引起肝酶升高、肌病等副作用的几率很低，通常为轻度或一过性升高，主要通过定期监测肌酶和肝功等发现和评价。
附：心血管健康关键数字
l 吸烟 0
l 血压 <140/90mmHg
l 总胆固醇 <5.2mmol/L（或LDL-C<130mg/dl）
l 腰围 <90/85cm (男/女
国家计委印发《关于中外合资、合作经营企业产品以产顶进办法》的通知(附英文)
国家计委
国家计委印发《关于中外合资、合作经营企业产品以产顶进办法》的通知(附英文)
1987年10月19日，国家计委
通知
根据《国务院关于鼓励外商投资的规定》，我委拟定的《关于中外合资、合作经营企业产品以产顶进办法》，已经国务院批准，现印发给你们，请参照执行。
附：关于中外合资、合作经营企业产品以产顶进办法
第一条 根据《国务院关于鼓励外商投资的规定》，为鼓励外商投资兴办先进技术企业，帮助企业解决外汇收支平衡，特制定本办法。
第二条 本办法适用于能够提供国内需要的先进技术，从事新产品开发实行产品升级换代的生产型中外合资经营、合作经营企业（以下简称合资、合作企业）。
第三条 符合下列各项条件的，可申请以产顶进：
一、确属国内需要的技术先进的技术型的合资、合作企业的产品，投产初期，在实现国产化进程中，外汇平衡出现暂时困难的；
二、上述企业生产的产品属于目前和今后几年中央、地方和部门需要进口的；
三、申请以产顶进的产品规格、性能、交货期和技术服务，培训应符合国内用户的需要，产品必须经过国家级产品质量检测中心鉴定，确认达到同类进口商品的质量标准，原则上价格不高于当时的国际市场价格。
第四条 凡要求以产顶进的企业，在申报项目建议书的同时，提出以产顶进的申请。在报送项目可行性研究报告时，必须明确合资、合作企业产品的内外销比例，以及国产化的进度，并对以产顶进的可行性（包括分年顶替进口的产品数量和外汇金额）进行充分论证或评估。
第五条 按分级管理原则、合资、合作企业产品申请以产顶进、分别由中央、地方（部门）两级审批。中央审批的限额以上项目需要以产顶进的，由国家计委审批；地方和部门审批的限额以下项目需要以产顶进的，由地方计委和部门自行审批。
第六条 由国家计委审批的限额以上项目的以产顶进：
一、凡已列入国家批准的中长期中央进口计划的商品，除去对外已签长期贸易协议和必须安排进口的以外，还有可能供以产顶进的，在审批可行性研究报告时，可预批中央进口计划期内的以产顶进。
二、没有列入中长期中央进口计划的商品，原则上不预批的以产顶进。但在年度中央进口计划中有这类商品进口且能以产顶进时，企业可向国家计委提出申请，批准后，由经贸部办理只在当年有效的以产顶进手续。
三、没有列入中长期和年度中央进口计划的商品，如当年地方有进口，企业可向地方计委提出申请，经批准后，由地方经贸部门办理以产顶进手续。
第七条 由地方、部门审批的限额以下项目的以产顶进：
一、凡已列入本省、自治区、直辖市的中长期和年度进口计划内可供以产顶进的商品，可由省、自治区、直辖市计委参照中央的审批办法，预批和办理本地区进口计划期内的以产顶进。
二、没有列入本地区中长期或年度计划，但本地区或其他地区有进口的，可实行跨地区的以产顶进。企业可向进口这一商品的省、自治区、直辖市计委申报，经批准后，由该省、自治区、直辖市经贸部门办理以产顶进手续。
三、部门用自有外汇进口的商品，企业可直接向该部门申请，经同意后，办理以产顶进手续。
第八条 上述中央和地方计委（或部门）审批同意以产顶进的产品，属于在中长期进口计划内预批的，必须根据当年的进口计划情况，在年度中进一步核定落实。
凡经批准实行以产顶进的产品，国内用户在同等条件下，必须优先选用。
各级进口管理部门和进口审查部门，对合资、合作企业已能生产并符合以产顶进条件的产品，应指导鼓励国内用户优先采购。
第九条 经批准的以产顶进产品，国内用户采购时，应按双方商定的条件，经国家外汇管理部门批准，向合资、合作企业支持全部或部分外汇。
第十条 机电产品的以产顶进，由国家经委制定并公布顶进目录和以产顶进管理办法，指导国内用户优先采购目录内的产品。
凡生产目录内产品的合资、合作企业可以参加中国机电设备招标中心（或经国家经委批准的招标公司）组织的进口机电设备招标，中标的企业，由该中心出具证明，实现以产顶进。
第十一条 合资、合作企业生产以产顶进产品所需进口的料、件、按《对外经济贸易部关于外商投资企业申领出口许可证的实施办法》第四条规定办理进口手续；上述产品供应给国内用户时，按海关总署《中华人民共和国海关对外商投资企业履行产品出口合同所需进口料、件管理办法》第五条规定办理。
第十二条 经批准其产品实行以产顶进合资、合作企业，必须做到：
一、严格执行合同中规定的出口比例和国产化进程的要求：
二、必须努力使产品的技术性能和质量保持先进水平；
三、按合同规定的数量、时间交货，因交货时间、交货数量和产品质量等问题造成用户经济损失者，要承担相应的经济责任。
四、为用户提供优质服务。
第十三条 合资、合作企业的产品一俟批准以产顶进后，不能再重复将这部分产品纳入国产物资分配计划。
第十四条 本办法由国家计委负责解释。
第十五条 本办法自公布之日起实行。
附：“七五”计划期间中央进口计划内可以实行以产顶进的商品目录
1．钢材
2．生铁
3．木材
4．铜
5．铝
6．锌
7．橡胶
8．化肥
9．木浆
10．腈纶
11．锦纶
12．人造丝
Measures for the Substitution of Importation by Products Manu-factured by Chinese-Foreign Equity Joint Ventures and Chinese-ForeignCooperative Joint Ventures
(Promulgated by the State Plan Commission on October 31, 1987)
Whole document
Measures for the Substitution of Importation by Products Manufactured by
Chinese-Foreign Equity Joint Ventures and Chinese-Foreign Cooperative
Joint Ventures
(Promulgated by the State Plan Commission on October 31, 1987)
Article 1
These measures are specially formulated pursuant to the "Provisions of
the State Council for the Encouragement of Foreign Investment" in order to
encourage foreign businessmen to invest in and establish technologically
advanced enterprises, and assist enterprises with foreign investment to
achieve a balance of foreign exchange receipts and payments.
Article 2
These measures are applicable to the productive Chinese-foreign equity
joint ventures and cooperative joint ventures (hereinafter "joint venture"
and "cooperative venture") which are capable of providing the advanced
technology needed by the country and involve in developing new products
and upgrading the existing products.
Article 3
Applications for import substitution treatment may be made if the
following conditions are met:
1. Temporary difficulties in balancing foreign exchange in the initial
period of operation are encountered in respect of the product made by a
joint venture or cooperative venture which has advanced technology needed
by the country and which is in the process of localizing source;
2. The products produced by the above mentioned enterprises are need
to be imported at present and will be needed to be imported in the next
few years by central and local authorities and relevant departments; and
3. The specification, performance, term of delivery and the conditions
of technical service and training of those products applied for import
substitution should meet the requirements of domestic customers, and the
products must be confirmed to reach the same quality standard as import
products of the same kind after being tested by a State-level product
quality examination center, and in principle, the prices are not higher
than current prices in international market.
Article 4
All enterprises which intending to ask for import substitution shall
request import substitution in the project proposal submitted for
examination and approval. In the feasibility study report submitted for
examination and approval, the proportion of the products for export and
domestic-sales, and the degree for increasing the indigenous components
and parts of the products shall be clearly specified. The feasibility of
import substitution (including the quantity of import products and the
amounts of foreign exchange involved on a yearly basis) shall also be
fully demonstrated or assessed.
Article 5
In accordance with the principle of administrative separation, the
application for import substitution of products of joint ventures and
cooperative ventures should be examined and approved either by the central
authorities or by local authorities (or departments). As for the project
within the examination and approval limits of the central authorities,
the application for import substitution shall be examined and approved by
the State Planning Commission. As for the project within the examination
and approval limits of the local authorities or departments the
application for import substitution shall be examined and approved by the
local planning commission or departments themselves.
Article 6
Import substitution for the projects within the examination and
approval limits of the central authorities shall be examined and approved
by the State Planning Commission:
1. In the case of products listed in the Central medium or long-term
import plan, except for those products for which foreign long-term trade
agreements have already been signed and those products for which imports
must be arranged, import substitution may be approved in advance for the
period covered by the central import plan at the time the feasibility
study report is examined and approved.
2. In principle, advance approval shall not be given for import
substitution of products which are not listed in the Central medium or
long-term import plan. However, if such products are listed in the Central
annual import plan and import substitution is possible, the enterprises
may apply to the State Planing Commission for import substitution. After
approval is granted the formalities for import substitution shall be
handled by the Ministry of Foreign Economic Relations and Trade and shall
be valid for that given year only.
3. As for the products not listed in the central medium and long-term
or annual import plan, the enterprises may, where importation of the
products is to be made locally in the given year, apply to local planning
commission. After the approval is granted, the formalities for import
substitution shall be handled by the local departments of foreign economic
relations and trade.
Article 7
Import substitution for projects within the examination and approval
limits of local authorities should be examined and approved by the local
authorities and departments:
1. In the case that the products are listed in the medium and
long-term or annual import plan of provinces, autonomous regions and
municipalities directly under the Central Government and suitable for
import substitution, the planning commission of the provinces, autonomous
regions and municipalities directly under the Central Government can
approve import substitution in advance for the period covered by the local
import plan; reference shall be made to central examination and approval
measures.
2. In the case that the products are not listed in the medium and
long-term or annual import plan of one region, but such products is to be
imported into that-region or other regions, import substitution may be
conducted transregionally. The enterprises may apply directly to the
planning commission of provinces and autonomous regions and municipalities
directly under the Central Government which is importing the products.
After approval is granted, the import substitution formalities shall be
handled by the local departments of foreign economic relations and trade
of such province, autonomous region or municipality directly under the
Central Government.
3. In the case that the products imported by the departments using
their own foreign exchange, the enterprises may apply directly to such
department for import substitution. If such department consents, it shall
handle the import substitution formalities.
Article 8
The above mentioned products of import substitution which have been
approved by the State or local planning commission (or department) in
advance for the period covered by the medium and long-term plan, must be
further checked and ratified each year, in accordance with the situation
of such import plan in such year.
Under the same conditions, domestic users shall select and use the
products approved for import substitution in reference to imports.
All levels of import administration and import examination and
approval authorities shall provide guidance to domestic users and
encourage them to buy the products produced by joint ventures and
cooperative ventures which conform to the conditions of import
substitution, in reference to imports.
Article 9
Domestic users shall pay the foreign exchange to joint ventures and
cooperative ventures totally or partially when they buy products approved
for import substitution according to the conditions agreed by both parties
upon permission by the foreign exchange central authorities.
Article 10
The State Economic Commission shall draw up and promulgate a list of
mechanical and electric products of import substitution and relevant
administrative measures, and provide the guidance to the domestic users to
buy the products on the list, in reference to imports.
Joint ventures and cooperative ventures that produce the products on
such list, may enter bids in tenders organized by the China Machine and
Electrical Equipment Tendering Center (or other tendering companies
approved by the State Economic Commission). If an enterprise wins the
render, it may carry out the import substitution on the basis of the
certificate issued by the Center.
Article 11
The import procedures of the materials and parts which must be
imported by the joint ventures and cooperative ventures to produce the
import substitution products shall be handled according to the Article 4
of "Implementation Measures of the Ministry of Foreign Economic Relations
and Trade Concerning the Application for Import and Export Licenses by
Enterprises with Foreign Investment". When the products mentioned above
are supplied to domestic users, it shall be handled according to the
Article 5 of the" Measures of the Customs Authority of the People's
Republic of China for the Control of Materials and Parts Required to be
Imported for the Performance of Product Export Contracts by Enterprises
with Foreign Investment".
Article 12
The joint ventures and cooperative ventures whose products have been
approved for import substitution shall:
1. strictly carry out the contract requirements regarding the
proportion of export sales and the process of raising the indigenous
components and parts of the products,
2. strive maintain the technical performance and quality of the
products at the world advanced levels; and
3. deliver the products according to the quantity and the time
required in the contract. The enterprises which cause economic losses to
users because of problems in the amount or quality of products or the
delivery time, etc., shall bear corresponding economic responsibility.
4. provide the best service to users.
Article 13
Once the products of joint ventures and cooperative ventures being
approved for import substitution, such products shall not be included in
the allocation plan of the materials produced in domestic.
Article 14
The State Planning Commission shall be responsible for interpreting
these Measures.
Article 15
These Measures shall enter into force on the date of promulgation.