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在初级阿尔多斯特主义查测试期间进行抗高血压治疗的实用建议
Jialin Li1, Hongzhou Yan2, Ling Li1
1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo City, Zhejiang Province, China.
Endocrine
|November 4, 2023
概括
抗高血压药物,如β-阻断剂和ARBs,可能会影响初级阿尔多斯特隆症 (PA) 查. 对于初始的阿尔多与蛋白活性比率 (ARR) 测试,建议继续使用这些常见的药物类别.
科学领域:
- 内分泌学 在内分泌学.
- 高血压管理 高血压管理
- 临床生物化学 临床生物化学
背景情况:
- 阿尔多与的活性比率 (ARR) 是一次性阿尔多学 (PA) 的关键查工具.
- 解释ARR结果受到同时使用抗高血压药物的显著影响.
研究的目的:
- 评估各种抗高血压药物类别对PA查中使用的生物化学标记物的影响.
- 为接受PA评估的患者提供基于证据的抗高血压药物治疗方案建议.
主要方法:
- 在2020年1月至2023年2月期间对PA进行查的4218名高血压患者的回顾性分析.
- 包括25名基本高血压 (EH) 和39名PA患者,其中EH患者在重复测试前至少4周改变了药物.
主要成果:
- 11.1%的EH患者在停止ARB,ACEI,DHP-CCB或利尿剂后显示了查结果的改变.
- 百分之百的接受β-阻断剂的患者最初的查结果呈阳性,但在停药后变得阴性.
- 药物影响导致7.7%的PA患者误诊.
- 药物后洗后血蛋白活性显著下降 (P=0.0173).
结论:
- 退出或切换β-阻断剂,ACEI,ARB和DHP-CCBs并不总是对于检查结果为负的患者来说是必要的.
- 建议在PA的初始ARR测试期间保持包括β抑制剂,ACEI,ARB,DHP-CCB和螺旋在内的疗法.
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