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近30年来利尿剂被广泛应用于高血压病及其他心血管病的治疗。噻嗪类降压利尿剂常作为治疗高血压病首选药。该药通过排钠利尿、减少血容量使血压下降。老年高血压患者,多为低肾素性高血压,故适用本制剂。但长期使用,易导致脱水和电解质紊乱。尤其低钾血症可致室性早搏,尽管无症状,但对老年人是不容忽视的。关于利尿剂治疗并发低钾血症和室性心律失常有关问题的研究报道很多,但迄今仍无定论。各家报道不一的原因是对于利尿剂和心律失常研究设计方案存在某些问题。即安慰剂的应用、利尿剂的用量(超量应用)、患者的选择(可能既往有心律失常或低钾血症),故在研究中可能有片面性。 Myers氏以慢性高龄患者为研究对象,采用随机双盲设计方法,选择65岁以上,近2年内无失代偿
Diuretics have been widely used in the treatment of hypertension and other cardiovascular diseases for nearly 30 years. Thiazide antihypertensive diuretics often used as the preferred drug for the treatment of hypertension. The drug through natriuresis, reduce blood volume so that blood pressure drops. Elderly patients with hypertension, mostly low renin hypertension, it is suitable for this preparation. However, long-term use can easily lead to dehydration and electrolyte imbalance. In particular, hypokalemia can cause premature ventricular contractions, although asymptomatic, but the elderly can not be ignored. There are many reports on the related issues of diuretic therapy for hypokalemia and ventricular arrhythmia, but so far it is still inconclusive. Various reports vary because of certain problems with the design of diuretics and arrhythmias. Ie placebo, diuretic (overdose), patient choice (with previous arrhythmia or hypokalemia) and may be one-sided in the study. Myers’s chronic elderly patients as the research object, using a randomized double-blind design method, choose 65 years of age, nearly two years without loss of life