糖尿病与血脂袁群—培训课件.ppt

* * * * * 舒降之(辛伐他汀)对医疗资源使用的影响 NFG IFG DM 减少心血管疾病 –23% –30% –40%住院数 / 100人 (P=0.001) (P=0.015) (P=0.007) 降低心血管疾病 – 28% –38% –55%总住院天数 (P 0.001) (P=0.005) (P 0.001) 摘自：Herman WH et al Diabetes Care 1999;22:1771-1778. 辛伐他汀4S研究糖尿病患者延伸分析 * 4S：每名患者折算后的CVD相关住院及药物费用 CVD费用（美元/患者） 0 5000 10000 15000 20000 -60% -74% -1800 舒降之 安慰剂 (NFG) 舒 安 (IFG) 舒 安 (DM) 药物治疗费用 住院费用 -3585 -4478 -7678 * * * * Slide 3 Atherothrombosis: a Generalized and Progressive Process Atherothrombosis is the common underlying disease process for MI, ischemia and vascular death. ACS are classic examples of atherothrombosis (plaque rupture and thrombus formation). ACS (in common with ischemic stroke and critical leg ischemia) are typically caused by rupture or erosion of an atherosclerotic plaque followed by formation of a platelet-rich thrombus. Atherosclerosis is an ongoing process affecting mainly large and medium-sized arteries, which can begin in childhood and progress throughout a person’s lifetime. Stable atherosclerotic plaques may encroach on the lumen of the artery and cause chronic ischemia, resulting in (stable) angina pectoris or intermittent claudication, depending on the vascular bed affected. Unstable atherosclerotic plaques may rupture, leading to the formation of a platelet-rich thrombus that partially or completely occludes the artery and causes acute ischemic symptoms. * * * * * * * * * Five major morbidity and mortality statin studies in primary or secondary prevention populations have been completed. This pyramid ranks the studies according to the type of patients that were included in each study. It begins with AFCAPS/TexCAPS, a primary prevention study in patients at low risk of CHD and moves to a smaller group of high-risk CHD patients in 4S, a secondary prevention study. In between the two extremes, covering the majority of patients with and at risk of CHD, are WOS, CARE, and LIPID. The Cholesterol and Recurrent Events (CARE) and Long-Term Intervention With