混合型血脂异常与糖尿病血脂干预-郭晓蕙

《混合型血脂异常与糖尿病血脂干预-郭晓蕙》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、混合型血脂异常与糖尿病血脂干预关注糖尿病患者LDL-C,HDL-C和TG的全面控制内容血脂异常与心血管风险2型糖尿病混合型血脂异常与心血管预后2型糖尿病混合型血脂异常干预的终点证据LDL-C:他汀临床研究关注的主要血脂指标AdaptedfromBallantyneCM.AmJCardiol.1998;82:3Q-12Q.二级预防-安慰剂二级预防-他汀一级预防-安慰剂一级预防-他汀0510152025308090100110120130140150160170180190200LDL-CAchieved(mg/dL)AFCAPSAFCAPSWOSCOPSWOSCOPSC

2、ARECARELIPIDLIPID4S4SEventRate(%)HPSHPS低HDL-C与冠心病危险TheindependenteffectofraisingHDL-Candloweringtriglyceridesontheriskofcoronaryandcardiovascularmorbidityandmortalityhasnotbeendetermined.Systolicbloodpressure=135mmHgKannelWB.AmJCardiol.1987;59:80A–90A.LDL-CCHDrelativerisk2.6mmol/L4.1mmo

3、l/L2.2mmol/L00.51.01.52.03.02.51.7mmol/L1.2mmol/L0.6mmol/L5.7mmol/LHDL-CFraminghamHeartStudyTG与CHD危险:Meta-Analysis*Individualsintopvsbottomthirdofusuallog-TGvalues,adjustedforatleastage,sex,smokingstatus,lipidconcentrations,andbloodpressure(most).SarwarNetal.Circulation.2007;115:450-458

4、,N=262,52512CHDRiskRatio*(95%CI)1.72(1.56–1.90)AdjustedforHDLFastingstatusDurationoffollow-up5689No4469Yes2674Nonfasting7484Fasting1994Female7728Male4256<10years590210yearsCHDCasesGroupsSex4S研究:血脂异常三联症干预结果(LDL+LowHDL+HighTG)LDL=low-densitylipoprotein;HDL=high-densitylipoprotein;TG=trig

5、lycerides.CVEventRate(%)4037.524.235.5血脂异常三联症,糖尿病血脂异常三联症,非糖尿病非血脂异常三联症,糖尿病非血脂异常三联症,非糖尿病3319718819221817941782n18.137.523.425.919.001020304050安慰剂辛伐他汀BallantyneCM.Circulation.2001;140:3046-3051治疗一年后相对基线的变化BallantyneCM.Circulation.2001;104:3046-3051.LipidTriadGroup:Baseline:LDL-C=195mg/dL,T

6、G=191mg/dL,HDL-C=33mg/dL;LipidTriadGroup:n=424;Sim:n=206;Placebo:n=218.35.7%simvastatinpatientsweretitratedfrom20to40mgat1year.辛伐他汀显著改善冠心病合并糖尿病患者血脂异常三联症4S研究内容血脂异常与心血管风险2型糖尿病混合型血脂异常与心血管预后2型糖尿病混合型血脂异常干预的终点证据亚洲各国面临2型糖尿病的巨大挑战(2003-2025）NumberofPeoplewithDiabetes(000)Source:http://www.eatlas

7、.idf.org/prevalence/index(accessed10/7/2005)糖尿病与心血管疾病BellDSH.DiabetesCare.2003;26:2433-41.CentersforDiseaseControl(CDC).www.cdc.gov.2型糖尿病的心血管并发症~65%的患者死于CV冠心病死亡2-4倍中风2-4倍心衰2-5倍冠心病患者的糖代谢状况欧洲心脏研究包括2107急性冠心病住院患者和2854例稳定性冠心病门诊患者BartnikMetal.EurHeartJ.2004;25:1880-90.Totalpatien