1.參考用
2.到底過了沒，我也忘記了
（印象中是沒過，不過好像大原則差不多）
3.回到第一點，僅供參考，被砍不要找我
4.這一個版本的很明確，簡單易懂，不像之前的那麼複雜
比較大的爭議點是：
(二)缺血型腦血管疾病病人：
1.腦梗塞。
2.腦內出血(不含其他顱內出血)。(原給付規定內容，諮詢神經內科專家意見)
3.陣發性腦缺血(TIA)。 (諮詢神經內科專家意見)
4.有症狀之頸動脈狹窄。(諮詢神經內科專家意見)
【忘記過了沒？！】高血脂用藥指引請參考全民健康保險藥品給付規定
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Re: 【忘記過了沒？！】高血脂用藥指引請參考全民健康保險藥品給付規定
草原上有對獅子母子
小獅子問母獅子：「媽媽，幸福在哪裡？」
母獅子說：「幸福就在你的尾巴上啊。」
於是，小獅子不斷地追著尾巴跑......但始終咬不到。
母獅子笑道：「傻瓜，幸福不是這樣得到的。只要你昂首向前走，幸福就會一直跟隨著你。」
小獅子問母獅子：「媽媽，幸福在哪裡？」
母獅子說：「幸福就在你的尾巴上啊。」
於是，小獅子不斷地追著尾巴跑......但始終咬不到。
母獅子笑道：「傻瓜，幸福不是這樣得到的。只要你昂首向前走，幸福就會一直跟隨著你。」
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tibet
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tibet
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Re: 【忘記過了沒？！】高血脂用藥指引請參考全民健康保險藥品給付規定
2012 ESC guideline:
statin class I in non-cardioembolic stroke or TIA
but:
Secondary prevention: Following stroke or TIA, patients are at risk not only of recurrent cerebrovascular events but also of other major CV events including MI. Secondary prevention therapy with statins reduces the risk of stroke, MI, and vascular death. However, the aetiology of stroke may influence the response to statins, and those patients with evidence of atherothrombosis underlying their cerebrovascular events appear to benefit most, while those with haemorrhagic stroke may not benefit or may even be harmed by statins, particularly if patients do not have evidence of atherosclerotic disease. A recent meta-analysis suggests that nicotinic acid alone or in combination with statin may add further benefit in stroke prevention. Table 31 lists the recommendations for lipid-lowering drugs for primary and secondary prevention of stroke.
2010 AHA stroke secondary prevention guideline:
1.tx LDL increase hemorragic stroke(HPS, SPARCL trail).
2.for low HDL, tx with niacin and gembifrozil(in VA-HIT) may be considered.(IIb/B).
3.consider metabolic syn. as a risk factor in secondary prevention.
因此:腦出血不應使用statin!!
statin class I in non-cardioembolic stroke or TIA
but:
Secondary prevention: Following stroke or TIA, patients are at risk not only of recurrent cerebrovascular events but also of other major CV events including MI. Secondary prevention therapy with statins reduces the risk of stroke, MI, and vascular death. However, the aetiology of stroke may influence the response to statins, and those patients with evidence of atherothrombosis underlying their cerebrovascular events appear to benefit most, while those with haemorrhagic stroke may not benefit or may even be harmed by statins, particularly if patients do not have evidence of atherosclerotic disease. A recent meta-analysis suggests that nicotinic acid alone or in combination with statin may add further benefit in stroke prevention. Table 31 lists the recommendations for lipid-lowering drugs for primary and secondary prevention of stroke.
2010 AHA stroke secondary prevention guideline:
1.tx LDL increase hemorragic stroke(HPS, SPARCL trail).
2.for low HDL, tx with niacin and gembifrozil(in VA-HIT) may be considered.(IIb/B).
3.consider metabolic syn. as a risk factor in secondary prevention.
因此:腦出血不應使用statin!!