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目的:探讨老年药源性高血压的临床特点、发病规律,为临床老年患者用药提供相关的参考依据。方法:回顾分析2011年1月—2012年12月医院老年科诊治的83例老年药源性高血压。结果:引起老年药源性高血压的药物有25种药物,其中以糖皮质激素类药物最为常见,占27.7%,其次是促红素,占总数的14.5%,以及非甾体类抗炎药和影响中枢神经的药物,各占13.3%。此外,中药制剂、血管生成抑制剂、含钠药物等也可导致药源性高血压。老年药源性高血压的临床症状与原发性高血压类似,但以高血压3级为主,收缩压平均增高幅度在(37.3±19.5)mmHg,舒张压平均增高的幅度在(12.0±9.9)mmHg。结论:老年药源性高血压在临床上并不少见,对于可能导致高血压的药物,用药时需要加强血压的监测,一旦发生药源性高血压,尽可能地撤药或更换其他药物。
Objective: To explore the clinical features and pathogenesis of drug-induced hypertension in the elderly and to provide relevant references for the clinical use of drugs in elderly patients. Methods: A retrospective analysis of January 2011 - December 2012 hospital geriatric treatment of 83 cases of elderly drug-induced hypertension. Results: Drugs that cause drug-induced hypertension in the elderly have 25 drugs, of which glucocorticoid drugs are the most common, accounting for 27.7%, followed by erythropoietin, accounting for 14.5% of the total, and non-steroidal anti-inflammatory drugs And affect the central nervous system drugs, each accounting for 13.3%. In addition, traditional Chinese medicine preparations, angiogenesis inhibitors, sodium-containing drugs can also lead to drug-induced hypertension. Symptoms of senile drug-induced hypertension are similar to those of essential hypertension. However, the main cause of hypertension is Grade 3, the average increase of systolic blood pressure is (37.3 ± 19.5) mmHg, and the average increase of diastolic blood pressure is (12.0 ± 9.9) ) mmHg. Conclusion: Elderly drug-induced hypertension is not uncommon in clinical practice. For those drugs that may cause high blood pressure, it is necessary to strengthen the monitoring of blood pressure during drug use. In the event of drug-induced hypertension, withdrawal or replacement of other drugs is possible.