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目的分析血液透析并高血压患者临床应用降压药的选择、用药方法及其降压效果,旨在为血液透析并高血压患者降压治疗提供依据。方法观察40例血液透析并高血压患者,对其降压药的选择、用药方法及其降压效果进行回顾性分析。结果血液透析并高血压患者,平均血压水平(160.1±15.4)/(100.3±7.0)mm Hg,血压控制程度欠佳。95%患者联合用药,其中钙拮抗剂选择种类多,用量大,65%超出药物推荐剂量。ACEⅠ、ARB、利尿剂应用比例不足,与担心药物的副作用有关。具体降压药物选择上,血液透析对药物动力学的影响考虑较少。结论血液透析并高血压患者在降压药的选择上,应加强ACEI、ARB、利尿剂的应用,注意血液透析对药物动力学的影响,选择不易被血液透析清除的药物。
Objective To analyze the choice of antihypertensive drugs and its antihypertensive effect in hemodialysis patients with hypertension and its antihypertensive effect, and to provide a basis for antihypertensive treatment in patients with hemodialysis and hypertension. Methods Forty patients with hemodialysis and hypertension were retrospectively analyzed on the choice of antihypertensive drugs, the method of using them and the antihypertensive effect. Results In hemodialysis patients with hypertension, the average blood pressure was (160.1 ± 15.4) / (100.3 ± 7.0) mm Hg, and the degree of blood pressure control was poor. 95% of patients combined medication, including calcium antagonist selection of many types, dosage, 65% beyond the recommended dose of the drug. ACE Ⅰ, ARB, diuretics less than the proportion of applications, and worry about the side effects of drugs. Specific antihypertensive drug choice, hemodialysis on pharmacokinetic considerations less. Conclusion Hemodialysis and hypertension in the choice of antihypertensive drugs should be strengthened ACEI, ARB, diuretics, pay attention to the effect of hemodialysis on pharmacokinetics, choose not easy to be cleared of hemodialysis drugs.