{"id":34487,"date":"2018-08-04T01:00:00","date_gmt":"2018-08-09T04:36:26","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/2018\/08\/09\/%e4%b8%89%e7%b1%bb%e5%b8%b8%e7%94%a8%e9%99%8d%e5%8e%8b%e8%8d%af%e7%89%a9%ef%bc%9a%e7%a6%81%e5%bf%8c%e8%af%81%e5%8f%8a%e6%b3%a8%e6%84%8f%e4%ba%8b%e9%a1%b9%ef%bc%81\/"},"modified":"2018-08-09T12:36:28","modified_gmt":"2018-08-09T04:36:28","slug":"%e4%b8%89%e7%b1%bb%e5%b8%b8%e7%94%a8%e9%99%8d%e5%8e%8b%e8%8d%af%e7%89%a9%ef%bc%9a%e7%a6%81%e5%bf%8c%e8%af%81%e5%8f%8a%e6%b3%a8%e6%84%8f%e4%ba%8b%e9%a1%b9%ef%bc%81","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/34487\/","title":{"rendered":"\u4e09\u7c7b\u5e38\u7528\u964d\u538b\u836f\u7269\uff1a\u7981\u5fcc\u8bc1\u53ca\u6ce8\u610f\u4e8b\u9879\uff01"},"content":{"rendered":"
\n

\"\u4e09\u7c7b\u5e38\u7528\u964d\u538b\u836f\u7269\uff1a\u7981\u5fcc\u8bc1\u53ca\u6ce8\u610f\u4e8b\u9879\uff01\"<\/p>\n

\u4f5c\u8005\uff1a\u6c5f\u95e8\u5e02\u4e2d\u5fc3\u533b\u9662 \u5f20\u658c<\/span>
<\/span><\/p>\n

\u6765\u6e90\uff1a\u533b\u5b66\u754c\u5fc3\u8840\u7ba1\u9891\u9053<\/span><\/p>\n

\u4e00\u53f7\u4eba\u7269\uff1aACEI\uff08\u8840\u7ba1\u7d27\u5f20\u7d20\u8f6c\u5316\u9176\u6291\u5236\u5242\uff09<\/span><\/strong><\/span><\/p>\n

\u4ee3\u8868\uff1a\u4f9d\u90a3\u666e\u5229\u3001\u5361\u6258\u666e\u5229\u3001\u82ef\u90a3\u666e\u5229\u3001\u8d56\u8bfa\u666e\u5229\u7b49<\/span><\/strong><\/span><\/p>\n

ACEI\u662f\u901a\u8fc7\u7ade\u4e89\u6027\u6291\u5236ACE\uff08\u8840\u7ba1\u7d27\u5f20\u7d20\u8f6c\u5316\u9176\uff09\u53d1\u6325\u964d\u538b\u4f5c\u7528\u7684\u4e00\u7c7b\u836f\u7269\u3002\u81ea20\u4e16\u7eaa80\u5e74\u4ee3\u4e0a\u5e02\u4ee5\u6765\uff0c\u5927\u91cf\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u663e\u793a\uff0c\u8be5\u7c7b\u836f\u7269\u5bf9\u4e8e\u9ad8\u8840\u538b\u60a3\u8005\u5177\u6709\u826f\u597d\u7684\u9776\u5668\u5b98\u4fdd\u62a4<\/strong>\u548c\u5fc3\u8840\u7ba1\u7ec8\u70b9\u4e8b\u4ef6\u9884\u9632<\/strong>\u4f5c\u7528\uff0cACEI\u4ee5\u5176\u663e\u8457\u7684\u964d\u538b\u4f5c\u7528\u53ca\u5e7f\u6cdb\u7684\u5e94\u7528\u8303\u56f4\u6210\u4e3a\u9ad8\u8840\u538b\u6cbb\u7597\u7684\u57fa\u77f3\u4e4b\u4e00\u3002<\/span><\/p>\n

\n

\u867d\u7136ACEI\u5177\u6709\u826f\u597d\u7684\u8010\u53d7\u6027\uff0c\u4f46\u4ecd\u53ef\u80fd\u51fa\u73b0\u7f55\u89c1\u4e14\u5371\u9669\u7684\u4e0d\u826f\u53cd\u5e94\uff0c\u5176\u7981\u5fcc\u8bc1\u5982\u4e0b\uff1a<\/span><\/p>\n

\uff081\uff09\u7edd\u5bf9\u7981\u5fcc\u8bc1\uff1a<\/strong><\/em><\/span><\/p>\n

\u2460\u598a\u5a20\uff1a<\/strong>ACEI\u53ef\u5f71\u54cd\u80da\u80ce\u53d1\u80b2\uff0c\u80b2\u9f84\u5973\u6027\u4f7f\u7528ACEI\u65f6\u5e94\u91c7\u53d6\u907f\u5b55\u63aa\u65bd<\/strong>\uff1b\u8ba1\u5212\u598a\u5a20\u7684\u5973\u6027\u5e94\u907f\u514d\u4f7f\u7528ACEI\uff1b<\/span><\/p>\n

\u2461\u8840\u7ba1\u795e\u7ecf\u6027\u6c34\u80bf\uff1a<\/strong>\u53ef\u5f15\u8d77\u5589\u5934\u6c34\u80bf\uff0c\u547c\u5438\u9aa4\u505c\u7b49\u4e25\u91cd\u4e0d\u826f\u53cd\u5e94\uff0c\u5371\u9669\u6027\u5927\uff1b\u4e34\u5e8a\u4e00\u65e6\u6000\u7591\u8840\u7ba1\u795e\u7ecf\u6027\u6c34\u80bf\uff0c\u60a3\u8005\u5e94\u7ec8\u8eab\u907f\u514d\u4f7f\u7528ACEI\uff1b<\/span><\/p>\n

\u2462\u53cc\u4fa7\u80be\u52a8\u8109\u72ed\u7a84\uff1a<\/strong>\u53ef\u56e0\u6025\u6027\u80be\u7f3a\u8840\u80be\u5c0f\u7403\u704c\u6ce8\u538b\u4e0d\u8db3\u5f15\u8d77\u6025\u6027\u80be\u635f\u4f24\uff1b<\/span><\/p>\n

\u2463\u9ad8\u94be\u8840\u75c7\uff08\uff1e6.0 mmol\/L\uff09\uff1a<\/strong>ACEI\u6291\u5236\u919b\u56fa\u916e\u7684\u5206\u6ccc\u5bfc\u81f4\u8840\u94be\u6d53\u5ea6\u7684\u5347\u9ad8\uff0c\u8f83\u5e38\u89c1\u4e8e\u6162\u6027\u5fc3\u529b\u8870\u7aed<\/strong>\u3001\u80be\u529f\u80fd\u4e0d\u5168<\/strong>\u4ee5\u53ca\u8865\u5145\u94be\u76d0<\/strong>\u6216\u8054\u7528\u4fdd\u94be\u5229\u5c3f\u5242<\/strong>\u7684\u60a3\u8005\u3002<\/span><\/p>\n

\uff082\uff09\u76f8\u5bf9\u7981\u5fcc\u8bc1\uff1a<\/strong><\/span><\/em><\/span><\/p>\n

\u2460\u8840\u808c\u9150\u6c34\u5e73\u663e\u8457\u5347\u9ad8<\/strong>\uff08\uff1e265 \u03bcmol\/L\uff09\uff1b<\/span><\/p>\n

\u2461\u9ad8\u94be\u8840\u75c7<\/strong>\uff08\uff1e5.5 mmol\/L\uff09\uff1b<\/span><\/p>\n

\u2462\u6709\u75c7\u72b6\u7684\u4f4e\u8840\u538b<\/strong>\uff08\uff1c90 mmHg\uff09\uff0c\u591a\u89c1\u4e8e\u5fc3\u529b\u8870\u7aed\uff0c\u8840\u5bb9\u91cf\u4e0d\u8db3\u7b49RAAS\u6fc0\u6d3b\u7684\u60a3\u8005\uff1b<\/span><\/p>\n

\u2463\u6709\u598a\u5a20\u53ef\u80fd\u7684\u5973\u6027<\/strong>\uff1b<\/span><\/p>\n

\u2464\u5de6\u5ba4\u6d41\u51fa\u9053\u6897\u963b\u7684\u60a3\u8005<\/strong>\u3002<\/span><\/p>\n

\uff083\uff09\u4e34\u5e8a\u7528\u836f\u6ce8\u610f\u4e8b\u9879<\/strong><\/em><\/span><\/p>\n

\uff081\uff09\u5c3d\u91cf\u9009\u62e9\u957f\u6548\u5236\u5242\u4ee5\u5e73\u7a33\u964d\u538b\uff0c\u540c\u65f6\u907f\u514d\u4f7f\u7528\u5f71\u54cd\u964d\u538b\u6548\u679c\u7684\u836f\u7269\uff0c\u5982\u5927\u90e8\u5206\u975e\u753e\u4f53\u6297\u708e\u836f<\/strong>\uff08\u5176\u4e2d\u963f\u53f8\u5339\u6797\u5242\u91cf\u2265300 mg\u65f6\uff09\u3001\u6fc0\u7d20\u7b49\uff1b<\/span><\/p>\n

\uff082\uff09\u5e94\u7528ACEI\u6cbb\u7597\u524d\u5e94\u68c0\u6d4b\u8840\u94be<\/strong>\u3001\u8840\u808c\u9150<\/strong>\u4ee5\u53ca\u4f30\u7b97\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387<\/strong>\uff08eGFR\uff09\uff0c\u7ed9\u836f\u7531\u5c0f\u5242\u91cf\u5f00\u59cb\uff0c\u5728\u60a3\u8005\u53ef\u8010\u53d7\u7684\u524d\u63d0\u4e0b\uff0c\u9010\u6e10\u4e0a\u8c03\u81f3\u6807\u51c6\u5242\u91cf\uff1b\u6cbb\u75972~4\u5468\u540e\u5e94\u8bc4\u4ef7\u7597\u6548<\/strong>\u5e76\u590d\u67e5<\/strong>\u8840\u94be\u3001\u8840\u808c\u9150\u4e0eeGFR\uff0c\u82e5\u53d1\u73b0\u8840\u94be\u5347\u9ad8\uff08\uff1e5.5 mmol\/L\uff09\u3001eGFR\u964d\u4f4e\uff1e 30% \u6216\u8840\u808c\u9150\u589e\u9ad8\uff1e 30% \u4ee5\u4e0a\uff0c\u5e94\u51cf\u5c0f\u836f\u7269\u5242\u91cf\u5e76\u7ee7\u7eed\u76d1\u6d4b\uff0c\u5fc5\u8981\u65f6\u505c\u836f\uff1b<\/span><\/p>\n

\uff083\uff09\u51fa\u73b0\u5e72\u54b3<\/strong>\u3001\u4f4e\u8840\u538b<\/strong>\u7b49\u4e0d\u826f\u53cd\u5e94\u65f6\u5e94\u79ef\u6781\u5904\u7406\uff0c\u907f\u514d\u5f15\u8d77\u60a3\u8005\u6cbb\u7597\u4f9d\u4ece\u6027\u7684\u4e0b\u964d\uff1b<\/span><\/p>\n

\uff084\uff09\u82e5\u5355\u836f\u6cbb\u7597\u8840\u538b\u63a7\u5236\u4e0d\u4f73\u65f6\uff0c\u5219\u5e94\u8003\u8651\u52a0\u91cf\u6216\u91c7\u7528\u8054\u5408\u6cbb\u7597\u65b9\u6848\uff0c\u7981\u6b62ACEI\u4e0eARB\u8054\u5408\u4f7f\u7528\u3002<\/span><\/p>\n

\u4e8c\u53f7\u4eba\u7269\uff1aARB\uff08\u8840\u7ba1\u7d27\u5f20\u7d20\u53d7\u4f53\u963b\u6ede\u5242<\/span>\uff09<\/strong><\/span><\/p>\n

\u4ee3\u8868\uff1a\u6c2f\u6c99\u5766\u3001\u7f2c\u6c99\u5766\u3001\u574e\u5730\u6c99\u5766\u7b49<\/strong><\/span><\/p>\n

ARB\u662f\u7ee7ACEI\u540e\u5bf9\u9ad8\u8840\u538b\u53ca\u5fc3\u8840\u7ba1\u75be\u75c5\u7b49\u5177\u6709\u826f\u597d\u4f5c\u7528\u7684\u964d\u538b\u836f\u7269\u3002ARB\u4e0eACEI\u76f8\u6bd4\u540c\u6837\u5177\u6709\u826f\u597d\u7684\u964d\u538b\u6548\u679c\uff0c\u4e14\u65e0ACEI\u7684\u5e72\u54b3\u3001\u8840\u7ba1\u7d27\u5f20\u6027\u6c34\u80bf\u7b49\u4e0d\u826f\u53cd\u5e94\uff0c\u60a3\u8005\u6cbb\u7597\u4f9d\u4ece\u6027\u66f4\u9ad8\uff0c\u5df2\u6210\u4e3a\u4e00\u7ebf\u964d\u538b\u836f\u7269\uff0c\u5728\u4e34\u5e8a\u5f97\u5230\u4e86\u5e7f\u6cdb\u5e94\u7528\u3002<\/span><\/p>\n

ARB\u9664\u964d\u538b\u5916\uff0c\u8fd8\u5177\u6709\u5fc3\u8840\u7ba1\u3001\u80be\u810f\u4fdd\u62a4\u53ca\u6539\u5584\u7cd6\u4ee3\u8c22\u7684\u4f5c\u7528\uff0c\u4f18\u5148\u9009\u7528\u7684\u4eba\u7fa4\u5305\u62ec\u9ad8\u8840\u538b\u5408\u5e76\u5de6\u5ba4\u80a5\u539a<\/strong>\u3001\u5fc3\u529f\u80fd\u4e0d\u5168<\/strong>\u3001\u623f\u98a4<\/strong>\u3001\u51a0\u5fc3\u75c5<\/strong>\u3001\u7cd6\u5c3f\u75c5\u80be\u75c5<\/strong>\u3001\u5fae\u91cf\u767d\u86cb\u767d\u5c3f<\/strong>\u6216\u86cb\u767d\u5c3f<\/strong>\u3001\u4ee3\u8c22\u7efc\u5408\u5f81<\/strong>\u53ca\u4e0d\u80fd\u8010\u53d7ACEI\u7684\u60a3\u8005<\/strong>\uff0c\u5728\u4e34\u5e8a\u4e2d\u4e5f\u5e94\u6ce8\u610f\u5176\u4e0d\u826f\u53cd\u5e94\u53ca\u7981\u5fcc\u8bc1\u3002<\/span><\/p>\n

\uff081\uff09\u7981\u5fcc\u8bc1\uff1a<\/strong><\/em><\/span><\/p>\n

\uff081\uff09ARB\u53ef\u81f4\u7578<\/strong>\uff0c\u7981\u6b62\u7528\u4e8e\u598a\u5a20\u9ad8\u8840\u538b\u60a3\u8005\uff1b<\/span><\/p>\n

\uff082\uff09ARB\u6269\u5f20\u80be\u5c0f\u7403\u51fa\u7403\u5c0f\u52a8\u8109\uff0c\u5bfc\u81f4\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff08GFR\uff09\u4e0b\u964d\uff0c\u808c\u9150\u6c34\u5e73\u5347\u9ad8\uff0c\u8840\u94be\u5347\u9ad8\uff0c\u56e0\u6b64\u9ad8\u8840\u94be<\/strong>\u6216\u53cc\u4fa7\u80be\u52a8\u8109\u72ed\u7a84\u60a3\u8005<\/strong>\u7981\u7528ARB\u3002<\/span><\/p>\n

\uff082\uff09\u6ce8\u610f\u4e8b\u9879\uff1a<\/strong><\/em><\/span><\/p>\n

\uff081\uff09\u56e0ARB\u6269\u5f20\u80be\u5c0f\u7403\u51fa\u7403\u5c0f\u52a8\u8109\uff1e\u6269\u5f20\u80be\u5c0f\u7403\u5165\u7403\u5c0f\u52a8\u8109\uff0c\u80be\u5c0f\u7403\u6ee4\u8fc7\u538b\u4e0b\u964d\uff0c\u80be\u529f\u80fd\u51cf\u9000\u3001GFR\u4e0b\u964d\u3001\u8840\u808c\u9150\u548c\u8840\u94be\u6c34\u5e73\u5347\u9ad8\u3002\u56e0\u6b64\uff0c\u5bf9\u6162\u6027\u80be\u810f\u75c5\uff08chronic kidney disease\uff0cCKD\uff094\u671f\u62165\u671f\u60a3\u8005\uff0cARB\u521d\u59cb\u5242\u91cf\u51cf\u534a<\/strong>\u5e76\u4e25\u5bc6\u76d1\u6d4b\u8840\u94be<\/strong>\u3001\u8840\u808c\u9150\u6c34\u5e73<\/strong>\u53caGFR<\/strong>\u7684\u53d8\u5316\uff1b\u8840\u808c\u9150\u6c34\u5e73\u22653 mg\/dl \u8005\uff0c\u614e\u7528ARB\uff1b<\/span><\/p>\n

\uff082\uff09\u5355\u4fa7\u80be\u52a8\u8109\u72ed\u7a84\u60a3\u8005<\/strong>\u4f7f\u7528ARB\u5e94\u6ce8\u610f\u60a3\u4fa7\u53ca\u5065\u4fa7\u80be\u529f\u80fd\u53d8\u5316\uff1b<\/span><\/p>\n

\uff083\uff09\u6025\u6027\u51a0\u72b6\u52a8\u8109\u7efc\u5408\u5f81<\/strong>\u6216\u5fc3\u529b\u8870\u7aed<\/strong>\u60a3\u8005\uff0c\u5148\u4ece\u5c0f\u5242\u91cfARB\u8d77\u59cb\uff08\u7ea6\u5e38\u89c4\u5242\u91cf\u76841\/2\uff09\uff0c\u907f\u514d\u9996\u8fc7\u4f4e\u8840\u538b\u53cd\u5e94\uff0c\u9010\u6e10\u589e\u52a0\u5242\u91cf\u81f3\u60a3\u8005\u80fd\u591f\u8010\u53d7\u7684\u9776\u5242\u91cf\uff1b<\/span><\/p>\n

\uff084\uff09\u5bf9\u6709\u9ad8\u94be\u8840\u75c7<\/strong>\u548c\u80be\u635f\u4f24<\/strong>\u7684\u60a3\u8005\uff0c\u907f\u514d\u4f7f\u7528ARB+ACEI\uff0c\u5c24\u5176\u662fARB+ACEI+\u76d0\u76ae\u8d28\u6fc0\u7d20\u53d7\u4f53\u62ee\u6297\u5242\uff1b<\/span><\/p>\n

\uff085\uff09ARB\u81f4\u54b3\u55fd\u7684\u53d1\u751f\u7387\u8fdc\u4f4e\u4e8eACEI\uff0c\u4f46\u4ecd\u6709\u6781\u5c11\u6570\u60a3\u8005\u51fa\u73b0\u54b3\u55fd\u3002<\/span><\/p>\n

\u4e09\u53f7\u4eba\u7269\uff1aCCB\uff08\u9499\u901a\u9053\u963b\u6ede\u5242\uff09<\/strong><\/span><\/p>\n

\u4ee3\u8868\uff1a\u7ef4\u62c9\u5e15\u7c73\u3001\u785d\u82ef\u5730\u5e73\u3001\u5730\u5c14\u786b\u5353\u7b49<\/strong><\/span><\/p>\n

CCB\u53ef\u4f5c\u4e3a\u4e00\u7ebf\u964d\u538b\u836f\u7269\u7528\u4e8e\u5404\u5e74\u9f84\u6bb5\u3001\u5404\u79cd\u7c7b\u578b\u7684\u9ad8\u8840\u538b\u60a3\u8005\uff0c\u7597\u6548\u7684\u4e2a\u4f53\u5dee\u5f02\u8f83\u5c0f\uff0c\u4f46\u7531\u4e8e\u5176\u836f\u7406\u4f5c\u7528\uff0c\u4e5f\u5177\u6709\u76f8\u5e94\u7684\u7981\u5fcc\u8bc1\u3001\u4e0d\u826f\u53cd\u5e94\u548c\u6ce8\u610f\u4e8b\u9879\uff0c\u73b0\u603b\u7ed3\u5982\u4e0b\uff1a<\/span><\/p>\n

\uff081\uff09\u7981\u5fcc\u8bc1\uff1a<\/strong><\/em><\/span><\/p>\n

\uff081\uff09\u4e8c\u6c22\u5421\u5576\u7c7bCCB\uff1a<\/strong><\/em>\u660e\u786e\u7684\u8840\u7ba1\u6269\u5f20\u4f5c\u7528\uff0c\u77ed\u4e2d\u6548\u7684CCB \u5728\u964d\u538b\u7684\u540c\u65f6\u4f1a\u51fa\u73b0\u53cd\u5c04\u6027\u5fc3\u7387\u52a0\u5feb\uff0c\u76f8\u5bf9\u7981\u7528\u4e8e\u9ad8\u8840\u538b\u5408\u5e76\u5feb\u901f\u6027\u5fc3\u5f8b\u5931\u5e38\u60a3\u8005<\/strong>\uff1b<\/span><\/p>\n

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<\/span><\/p>\n<\/section>\n

\"\u4e09\u7c7b\u5e38\u7528\u964d\u538b\u836f\u7269\uff1a\u7981\u5fcc\u8bc1\u53ca\u6ce8\u610f\u4e8b\u9879\uff01\"<\/p>\n

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\n

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