继发性高血压诊断及治疗的新进展

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近年来广大医务工作者对高血压进行的大量研究工作,使得继发性高血压的鉴别诊断以及药物治疗方面取得不少进展,现简介如下。一、继发性高血压的鉴别诊断1.肾动脉狭窄性高血压的诊断:肾动脉狭窄或阻塞造成的高血压,肾素—醛固酮—血管紧张素系统起主要作用。肾动脉狭窄时,狭窄的远端压力下降,入球小动脉压力随之下降,于是刺激近球旁装置释放肾素,从而引起一系列内分泌改变造成血压升高。所以任何因素导致肾动脉压力下降,均可刺激肾素释放。目前临床诊断单侧肾动脉狭窄,除作肾动脉造影外,还应作分侧肾静脉血浆肾素活性(PRA)测定,来 In recent years, a large number of medical workers on hypertension carried out a large number of studies, making the differential diagnosis of secondary hypertension and drug treatment has made considerable progress, are as follows. First, the differential diagnosis of secondary hypertension 1. Renal artery stenosis diagnosis of hypertension: renal artery stenosis or obstruction caused by hypertension, renin - aldosterone - angiotensin system plays a major role. When the stenosis of the renal artery is narrowed, the pressure in the distal part of the stenosis decreases and the pressure in the arteriole decreases. As a result, the device is stimulated to release renin, which causes a series of endocrine changes to cause an increase in blood pressure. Therefore, any factor leading to decreased renal artery pressure, can stimulate the release of renin. The current clinical diagnosis of unilateral renal artery stenosis, in addition to renal artery angiography, but also for the lateral renal venous plasma renin activity (PRA) determination, to
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