选择正确的降脂治疗方案PPT课件.ppt

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1、ConsiderDrugRiskCategoryLDL-CGoalTherapyCHDorCHDriskequivalent<100mg/dL130mg/dL*2RiskFactors10-yrrisk10–20%<130mg/dL130mg/dL10-yrrisk<10%<130mg/dL160mg/dL<2RiskFactors<160mg/dL190mg/dL*100–129mg/dL=afterTLC,considerstatin,niacin,orfibratetherapyExpertPanelonDetection,E

2、valuation,andTreatmentofHighBloodCholesterolinAdults.JAMA2001;285:2486-2497.ExpertPanelonDetection,Evaluation,andTreatmentofHighBloodCholesterolinAdults.JAMA2001;285:2486-2497.LDLDailyDoseAtorvaFluvaLovaPravaSimva10mg–39%–22%–30%20mg–43%–22%–27%–32%–38%40mg–50%–25%–32%–34%–

3、41%80mg–60%–36%–42%–47%Physician’sDeskReference.55thed.Montvale,NJ:MedicalEconomics,2001.Lova20mg1%–9%–32%Prava10mg6%–11%–22%Simva10mg1%–20%–28%SteinEAetal.AmJCardiol1998;81:66B-69B.TrialDrugCHDRiskReductionPrimaryPreventionAFCAPS/TexCAPSLovastatin–40%*WOSCOPSPravastatin–31

4、%*SecondaryPrevention4SSimvastatin–34%*CAREPravastatin–24%*LIPIDPravastatin–24%*IschemiaMIRACLAtorvastatin–26%**AVERTAtorvastatin–36%***NonfatalMIorCHDdeath;**ischemiceventsDownsJRetal.JAMA1998;279:1615-1622.

5、ShepherdJetal.NEnglJMed1999;333:1301-1307.

6、ScandinavianSimvastati

7、nStudyGroup.Lancet1994;344:1383-1389.

8、SacksFMetal.NEnglJMed1996;335:1001-1009.

9、LIPIDStudyGroup.NEnglJMed1998;339:1349-1357.

10、SchwartzGGetal.JAMA2001;285:1711-1718.

11、PittBetal.NEnglJMed1999;341:70-76.+200–5–10–15–20–25–30–35–40–45–50MajorcoronaryeventsCoronarydeathsCardiovascu

12、lardeathsNoncardiovasculareventsTotalmortalityStrokesIntermittentclaudicationAnginaLaRosaJCetal.JAMA1999;282:2340-2346.

13、CrouseJRIIIetal.ArchInternMed1997;157:1305-1310.

14、PedersenTRetal.AmJCardiol1998;81:333-335.*TimecourseestablishednCommonsideeffectsnHeadache–Myalgia–Fatigu

15、enGIintolerance–Flu-likesymptomsnIncreaseinliverenzymesnOccursin0.5to2.5%ofcasesindose-dependentmannernSeriousliverproblemsareexceedinglyrarenManagebyreducingstatindoseordiscontinueuntillevelsreturntonormalnMyopathynOccursin0.2to0.4%ofpatientsnRarecasesofrhabdomyolysisnRedu

16、cebynCautiouslyusingstatinsinpatientswithimpairedrenalfunctionnUsingthelowesteffec