难治性高血压诊断和治疗分析

Difficult hypertension diagnosis and the treatment analyzes

目的：探讨难治性高血压（RH）的病因，总结临床诊治经验。方法：回顾性分析我院收治的46例RH患者的临床资料。结果：原发性高血压有40例（87．0％），继发性高血压6例（13．0％）；治疗依从性差（56．5％）和生活方式不良（17．4％）是主要原因，其次为治疗方案不合理（13．0％）和白大衣高血压（8．7％）。联合使用3种以上抗高血压药物，足剂量给药，进行正规化治疗后，血压控制在140／90mmHg以下者38例（82．6％），5例（10．9％）控制在150／95mmHg以下；3例（6．5％）继发性高血压因没有根除原发病，血压未达标。结论：RH要根据病史以及检查结果分析原因，治疗时联合使用3种以上抗高血压药物，足剂量给药，在提高依从性的基础上，改善生活方式、制定合理降压方案、个体化实施降压，以提高控制率。

Objeetive..The discussion difficult hypertension （RH） cause of disease, summarizes the clinical diagnosis experience. Methods： The re-blew analyzes my courtyard admitting 46 example RH patient＇s clinical material. Results：The primary hypertension has 40 examples （87.0K）, sequential hypertension 6 examples （13.0%）; The treatment compliance difference （56.5%） and the life style not good （17.4%） is the primary cause,next for treatment plan unreasonable （13.0%） and white coat hypertension （8. 7 %）. Jointly uses 3 kind of above anti--hypertension medicines, the full dosage gives the medicine,after carries on the standardized treatment,blood pressure control below 140/90mmHg 38 examples （82.6%）, 5 examples （10.9%） control below 150/95mmHg; Because 3 example （6.5 %） sequential hypertension has not eradicated the the primary affection,the blood pressure standards. Conelusion：RH must act according to the medical history as well as the inspection result analysis reason,when the treatment jointly uses 3 kind of above anti--hypertension medicines, the full dosage gives the medicine, in enhancement compliance foundation, improvement life style, formulation reasonable voltage dropping resistor plan, individuation implementation voltage dropping resistor, en- hances the inverse amplification factor.