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顽固性高血压在治疗上很辣手,预后也不佳。所谓顽固性高血压,是指用3种以上的降压药仍未能控制者。临床上常用的降压药是克尿噻、β受体阻断剂加上肼苯达嗪、甲基多巴或哌唑嗪.除利尿药和β受体阻断剂外的其他降压药均有增加血浆容量的倾向,即使同时使用足量的克尿噻亦会如此.由于血容量的增加削弱了上述药物的降压效果(假性耐药性)。本文作者用速尿代替上述方案中的克尿噻,或在上述方案的基础上加用安体舒通,从而增强了利尿效能、减低了患者的血容量,获得较好的降压疗效。
Refractory hypertension in the treatment is very hot, the prognosis is not good. The so-called refractory hypertension, refers to the use of more than three kinds of antihypertensive drugs still can not control. Antihypertensive drugs commonly used clinically urinary thiazide, β-blocker plus hydralazide, methyldopa or prazosin in addition to diuretics and β-blockers other antihypertensive drugs All have a tendency to increase plasma volume, even with the use of sufficient urotropin at the same time, which depress the antihypertensive effect (pseudo-resistance) of these drugs due to increased blood volume. The authors use furosemide instead of urotropine in the above scheme, or add spironolactone on the basis of the above scheme, thereby enhancing diuretic efficacy, reducing the patient’s blood volume and obtaining better antihypertensive efficacy.