社区脑卒中一级预防课件.ppt

内容提要 脑卒中一级预防的现状 脑卒中危险因素及其治疗与控制 阿司匹林与脑卒中一级预防 无症状颈动脉狭窄（CEA和CAS） 他汀类药物和中成药系统评价 申康医院慢病综合防治项目 Statins for the primary prevention of cardiovascular disease（2013） The latest search found four new trials and updated follow-up data on three trials included in the original review. Eighteen randomised control trials (19 trial arms; 56,934 participants) were included. Fourteen trials recruited patients with specific conditions (raised lipids, diabetes, hypertension, microalbuminuria）. 在原有的系统评价基础上增加了3项新的试验结果。总共18项随机对照研究（56,934例患者），其中14项研究选择有血脂紊乱、糖尿病、高血压、微量蛋白尿等有危险因素的个体。 All-cause mortality was reduced by statins (OR 0.86, 95% CI 0.79 to 0.94); as was combined fatal and non-fatal CVD RR 0.75 (95% CI 0.70 to 0.81), combined fatal and non-fatal CHD events RR 0.73 (95% CI 0.67 to 0.80) and combined fatal and non-fatal stroke (RR 0.78, 95% CI 0.68 to 0.89). Reduction of revascularisation rates (RR 0.62, 95% CI 0.54 to 0.72) was also seen. 他汀类药物应用于心血管病一级预防，总死亡、心脑血管总事件、冠状动脉事件、卒中事件以及血管重建率均显著降低。 Statin for the primary prevention of cardiovascular disease（2013） Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects. There was no evidence of any serious harm caused by statin prescription. Evidence available to date showed that primary prevention with statin is likely to be cost-effective and may improve patient quality of life. 欧美心血管疾病的发病率和死亡率显著降低，与他汀类药物的消耗显著相关。 Statins for the primary prevention of cardiovascular disease（2013） 中成药预防中风系统评价 Chuanxiong preparations to prevent stroke in people at high risk of stroke（2010） Three RCTs (5042 participants) were included. One higher quality study (4415 participants) compared Nao-an capsule with aspirin for primary prevention in high-risk stroke populations. Nao-an capsule appeared to reduce the incidence of stroke compared with aspirin (OR 0.56 95% CI 0.33 to 0.96). 内容提要 脑卒中一级预防的现状 脑卒中危险因素及其治疗与控制 阿司匹林与脑卒中一级预防 无症状颈动脉狭窄（CEA和CAS） 他汀类药物和中成药系统评价 申康医院慢病综合防治项目 上海市申康医院发展中心慢性病综合预防项目 项目编号：S