尚未确定用于监测降脂治疗效果的最佳方法。应每 6 周监测血脂水平直至低密度脂蛋白水平达标。[22]Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97.http://www.ncbi.nlm.nih.gov/pubmed/11368702?tool=bestpractice.com 在坚持生活方式修正和血脂水平稳定后,间隔时间可以延长到每6-12个月。
尽管毒性的发生率很低 (0.5%-2%),开始他汀类治疗时,应检测患者基线肝酶和肌酶水平。在美国,食品药品监督管理局 (FDA) 已声明,在使用他汀类药物时不必再常规检测肝酶。FDA 总结到,他汀类药物治疗引起的严重肝脏损伤是罕见的且不可预料的,因此常规周期性监测肝酶似乎并不能有效地发现和预防这种罕见的副作用。[100]US Food and Drug Administration. FDA drug safety communication: important safety label changes to cholesterol-lowering statin drugs. February 2012 [internet publication].https://www.fda.gov/Drugs/DrugSafety/ucm293101.htm
起始他汀治疗后,除非患者出现肌痛或其他肌肉症状,否则不必定期检查肌酶水平。[101]Smith CC, Bernstein LI, Davis RB, et al. Screening for statin-related toxicity: the yield of transaminase and creatine kinase measurements in a primary care setting. Arch Intern Med. 2003 Mar 24;163(6):688-92.http://archinte.ama-assn.org/cgi/content/full/163/6/688http://www.ncbi.nlm.nih.gov/pubmed/12639201?tool=bestpractice.com
尽管使用他汀类药物有很小的新发糖尿病的风险,尚没有正式的推荐更严密的监测血糖和糖化血红蛋白的水平,这些检查应根据患者的个人情况进行。