由印米他辛使用引发的高血压脑病变
Jane Plitman1, Vanessa Raco2, Peter E Wu1,3
1Department of Medicine University of Toronto Toronto Canada.
Clinical case reports
|November 21, 2024
概括
印米他辛是一种非类固醇抗炎药物 (NSAID),可以在患有高血压的老年人中引发高血压脑病. 停止使用NSAID和管理高血压可以解决患者的困惑和头痛.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 高血压脑病是一种神经疾病,其特征是急性混乱和血压升高.
- 非类固醇抗炎药物 (NSAIDs) 可以加剧潜在的高血压,特别是在老年患者中.
- 氨酸- ангиотензин- алдостерон (RAS) 系统在血压调节中起着至关重要的作用,其抑制可以增加对NSAID诱导并发症的易感性.
研究的目的:
- 报告一个高血压脑病症的病例,因因多米他辛在老年男性患者中引发.
- 突出NSAID在非控制高血压患者和服用RAS抑制药物的患者中使用的潜在风险.
- 强调在处方NSAID之前仔细评估患者的重要性.
主要方法:
- 一个70多岁的男性病人的病例报告呈现出急性混乱.
- 审查患者的病史,包括最近的印梅他辛处方和现有的高血压治疗与trandolapril.
- 临床检查,实验室检查和神经成像 (CT和MRI) 排除其他原因.
- 停止使用印梅他辛和使用安洛迪平治疗高血压.
主要成果:
- 患者出现了严重的高血压 (190/110毫米) 和急性混乱.
- 实验室和成像研究对急性神经过程或感染没有显著影响.
- 在停止服用印梅他辛并使血压正常化后,患者的困惑和头痛消失了.
- 该患者被诊断为因印米他辛诱导的高血压脑病变.
结论:
- 使用NSAID,包括印梅他辛,可以导致高血压脑病变,特别是在患有高血压的患者中.
- 服用抑制RAS系统的抗高血压药物的患者有较高的NSAID相关血压减补的风险.
- 临床医生必须仔细权衡NSAIDs的益处与风险,考虑患者的整体健康状况和药物治疗方案.
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