实证医学讨论会概要课件.ppt

《实证医学讨论会概要课件.ppt》由会员分享，可在线阅读，更多相关《实证医学讨论会概要课件.ppt（17页珍藏版）》请在淘文阁 - 分享文档赚钱的网站上搜索。

1、實證醫學討論會AngiotensinAngiotensin II receptor blockade reduces new-onset II receptor blockade reduces new-onset atrialatrial fibrillation and subsequent stroke compared to fibrillation and subsequent stroke compared to atenololatenolol The The LosartanLosartan Intervention For End point Intervention For

2、 End point reduction in hypertension(LIFE)studyreduction in hypertension(LIFE)study Journal of the American Journal of the American College of CardiologyCollege of Cardiology Volume 45,Issue 5Volume 45,Issue 5,1 March,1 March 2005,Pages 712-7192005,Pages 712-719 Dr.林百揚96.11.15Case Presentationn nNam

3、e：林鳳Xn n病歷號：26421134n n年紀：47 y/on n性別：FemaleChief Complaintn nPalpitation at night in 2007/11/6Present Illnessn nchills and fever for 4-5 days,n naccompanied with dizziness,head heavy sensation,neck stiffness,poor appetite,and bil.flank sorenessn nLab data at ERuuWBCWBC：1550015500uuCRP:217.8 CRP:217

4、.8 uuNaNa：124.6124.6uuK K：2.832.83uuU/A:WBC:70-80/HPFU/A:WBC:70-80/HPFPersonal Historyn nAllergy:deniedn n1.Medical history：Hypertension：nil Diabetes mellitus：nil Others：Visual field defect.n n2.Surgical history：s/p C/SPhysical Examinationn nConscious:clearn nTPR=36.7/140160/18,BP=135/92n nAbd:uuFla

5、t,no striae,no engorged veinuuSoft,no rebound painEKGn n2007/11/2 Normal Sinus Rhythmn n2007/11/6 Atrial fibrillationImpressionNew onset of atrial fibrillationClinical Problemsn nWhat is the treatments for a patient of new onset of atrial fibrillationn nPatient and/or problem:誰是相關的病人，是否具有何種問題？n nInt

6、ervention/or exposure：有興趣的治療處置、診斷工具或暴露因子為何？n nComparison(if relevant)：如果有的話，對照組的處置、診斷工具或暴露因子為何？n nOutcomes：與病人最相關之（可測量）結果是什麼？PICOn nPatient and/or problem:Atrial fibrillationn nIntervention/or exposure:EKG and EKG monitorn nComparison:new onset Af(no Af v.s.Af)etiologyn nOutcomes:the preferable trea

7、tments Key words 以Cochrane為例n n#1 atrial fibrillationn n#2 treatmentsn n#3 etiologyn n#4 new onsetn n#1 and#2 and#3 and#4 11 resultsKey words 以Cochrane為例n n#1 atrial fibrillationn n#2 treatmentsn n#3 comparisonn n#4 new onsetn n#1 and#2 and#3 and#4 PUBMED 16265553 Search Resultn nCan Can losartanlos

8、artan prevent new-onset prevent new-onset atrialatrial fibrillation in hypertensive patients more fibrillation in hypertensive patients more effectively than effectively than atenololatenolol?n nPUBMED 16265553 PUBMED 16265553 n nLink:Link:http:/wwwhttp:/ nAngiotensinAngiotensin II receptor blockade

9、 reduces new-II receptor blockade reduces new-onset onset atrialatrial fibrillation and subsequent stroke fibrillation and subsequent stroke compared to compared to atenololatenolol The The LosartanLosartan Intervention Intervention For End point reduction in hypertension(LIFE)For End point reduction in hypertension(LIFE)study study n nJournal of the American College of CardiologyJournal of the American College of Cardiology Volume 45,Issue 5Volume 45,Issue 5,1 March 2005,Pages 712-719,1 March 2005,Pages 712-719 n nhttp:/wwwhttp:/ You For Listening!