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高血压是器官移植受者术后常见的重要并发症之一,发病率70%~90%,明显高于普通人群18.8%~30.0%的高血压发病率。移植后高血压是导致移植物功能丧失和生存预后不良的重要危险因素。高血压与发生心血管并发症风险有显著相关性,可直接导致移植物功能丧失和患者死亡,成为受者带功能死亡的重要病因。然而移植后高血压控制率仅为30%~60%。指南推荐器官移植受者高血压诊断阈值为血压高于130/80mm Hg(1mm Hg=0.133k Pa);对于老年受者目标血压可放宽至140/90mm Hg;而年轻、肾功能好的患者目标血压亦不应低于120/70mm Hg。指南推荐器官移植受者家庭自我血压监测作为首选的血压监控方式。器官移植受者术后高血压有多种因素,虽然免疫抑制是移植后高血压发病的重要原因,但以治疗高血压为目的调整免疫抑制剂要全面了解免疫状况,权衡利弊,谨慎决定。指南推荐结合危险因素和患者实际临床状态制定个体化联合治疗方案,达到强化降压效果的同时,减轻药物的不良反应。《中国成人高血压诊疗指南》作为器官移植受者高血压评估分层方案的参考标准。
Hypertension is one of the most common postoperative complications in organ transplant recipients. The morbidity is 70% -90%, which is significantly higher than that of the general population (18.8% -30.0%). Hypertension after transplantation is an important risk factor leading to impaired graft function and poor survival prognosis. Hypertension and the risk of cardiovascular complications have a significant correlation, can lead directly to the loss of graft function and patient death, as the recipient with functional death is an important cause. However, post-transplant hypertension control rate of only 30% to 60%. Guidelines recommend that the threshold for diagnosis of hypertension in organ transplant recipients be higher than 130/80 mm Hg (1 mm Hg = 0.133 kPa) for hypertension and 140/90 mm Hg for elderly recipients; and that for younger patients with good renal function Blood pressure should not be less than 120 / 70mm Hg. Guidelines recommend organ transplant recipients self-monitoring of blood pressure as the preferred method of blood pressure monitoring. Organ transplant recipients postoperative hypertension there are many factors, although immunosuppression is an important cause of post-transplant hypertension, but to adjust the immune suppression for the purpose of hypertension to fully understand the immune status, weigh the pros and cons, be cautious. Guidelines recommend combination of risk factors and the actual clinical status of patients to develop individualized combination therapy to achieve the effect of reducing blood pressure, while reducing the adverse drug reactions. Guidelines for the Diagnosis and Treatment of Hypertension in Chinese Adults serve as a reference standard for the assessment of hypertension in transplant recipients.