高血压急重症的病情观察及处理PPT课件.ppt

* 硝酸酯类 由于硝酸酯类对动脉扩张弱，JNC VII未推荐其用于其它高血压急症，仅推荐用于高血压合并ACS Paul E, et al. Hypertensive Crises challenges and management. CHEST 2007. JNC VII: ，２００３年 * 高血压急症处理小结 控制血压 相对性（超出单纯降压 ） 靶器官损伤 进展性（重点保护靶器官） 急诊处理 紧迫性、节奏性 药物选择： 因病而异、因人而异 * 谢谢！ * 无论是在全球还是我国，高血压的现状均触目惊心。在第21届国际高血压学会(ISH2006)公布的福冈宣言中表明，全世界高血压患者约有9亿7200万，相当于成人的26.4%。我国的高血压病情流行现状同样不容乐观，据2002 年全国居民营养与健康状况调查资料显示，我国成人高血压患病率为18.8%，全国有高血压患者约1.6 亿。可以想见如此庞大的高血压人群如果血压不能得到有效控制，那么到2050年，轮椅一定非常畅销。 1％－2％的高血压患者发生过需要紧急治疗的血压急剧升高。快速发病表明存在触发因素叠加于原有的高血压基础上。 血压升高不伴有即刻脏器受损，对短期生存预后不产生影响； -高血压急症伴有脏器受损，对短期生存预后产生影响。 Organ injury is most common with a DBP 130 mm Hg unless the patient is a child or pregnant.15 In pregnant females a SBP 169 mm Hg or DBP 109 mm Hg is considered a hypertensive emergency and should be treated promptly.16 EPIDEMIOLOGY Hypertensive crisis affects 500,000 Americans or approximately Organ injury is most common with a DBP 130 mm Hg unless the patient is a child or pregnant.15 In pregnant females a SBP 169 mm Hg or DBP 109 mm Hg is considered a hypertensive emergency and should be treated promptly.16 EPIDEMIOLOGY Hypertensive crisis affects 500,000 Americans or approximately 对于高血压急症的临床诊断不是没有血压增高的标准, 而应以具体脏器损伤的情况决定,应符合“需要立即降压治疗”的原则, 即不同的靶 器官损害可能有不同的血压控制标准Organ injury is most common with a DBP 130 mm Hg unless the patient is a child or pregnant.15 In pregnant females a SBP 169 mm Hg or DBP 109 mm Hg is considered a hypertensive emergency and should be treated promptly.16 15.Varon J, Marik P. The diagnosis and management of hypertensive crises. Chest. 2000;118:214 –227. 16. Rey E, LeLorier J, Burgess E, et al. Report of the Canadian Society Consensus Conference: 3. Pharmacologic treatment of hypertensive disorders in pregnancy. CMAJ. 1997;157:1245–1254. EPIDEMIOLOGY Hypertensive crisis affects 500,000 Americans or approximately Organ injury is most common with a DBP 130 mm Hg unless the patient is a child or pregnant.15 In pregnant females a SBP 169 mm Hg or DBP 109 mm Hg is considered