Chinese General Practice ›› 2023, Vol. 26 ›› Issue (03): 274-279.DOI: 10.12114/j.issn.1007-9572.2022.0587
Special Issue: 述评栏目最新文章合集; 高血压最新文章合集
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Received:
2022-05-17
Revised:
2022-10-07
Published:
2023-01-20
Online:
2022-10-20
Contact:
ZHANG Lijing
About author:
通讯作者:
张立晶
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0587
药物类型 | 适应证 | 不良反应和注意事项 | 针对哮喘的考虑因素 |
---|---|---|---|
噻嗪类利尿剂 | 一线或附加药物 | 引起低血钾或低血钠 | 短效β-受体激动剂、茶碱和糖皮质激素用量增多的情况下,可降低血钾,需慎用 |
ACEI | 慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物 | 可升高血钾和肌酐水平;血管神经性水肿;妊娠妇女禁用 | 诱发咳嗽;诱发或加重哮喘,需慎用 |
ARB | 慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物 | 可升高血钾和肌酐水平;血管神经性水肿;妊娠妇女禁用 | 可降低支气管反应性;有望成为哮喘合并高血压一线选择 |
CCB | 一线或附加药物 | 水肿;与β-受体阻滞剂联用时,可能出现便秘和心脏传导阻滞 | 可能对平滑肌收缩和触发因素产生有益作用,因此建议哮喘合并高血压时首选 |
β-受体阻滞剂 | 不建议单药治疗;适用于充血性心力衰竭、心肌梗死和心律失常 | 可能出现心动过缓、疲劳、失眠;外周循环、糖脂代谢受损 | 可诱发支气管痉挛;哮喘病情不稳定患者和重度气流阻塞患者禁用 |
Table 1 The use of antihypertensive drugs and indications
药物类型 | 适应证 | 不良反应和注意事项 | 针对哮喘的考虑因素 |
---|---|---|---|
噻嗪类利尿剂 | 一线或附加药物 | 引起低血钾或低血钠 | 短效β-受体激动剂、茶碱和糖皮质激素用量增多的情况下,可降低血钾,需慎用 |
ACEI | 慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物 | 可升高血钾和肌酐水平;血管神经性水肿;妊娠妇女禁用 | 诱发咳嗽;诱发或加重哮喘,需慎用 |
ARB | 慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物 | 可升高血钾和肌酐水平;血管神经性水肿;妊娠妇女禁用 | 可降低支气管反应性;有望成为哮喘合并高血压一线选择 |
CCB | 一线或附加药物 | 水肿;与β-受体阻滞剂联用时,可能出现便秘和心脏传导阻滞 | 可能对平滑肌收缩和触发因素产生有益作用,因此建议哮喘合并高血压时首选 |
β-受体阻滞剂 | 不建议单药治疗;适用于充血性心力衰竭、心肌梗死和心律失常 | 可能出现心动过缓、疲劳、失眠;外周循环、糖脂代谢受损 | 可诱发支气管痉挛;哮喘病情不稳定患者和重度气流阻塞患者禁用 |
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