血浆置换法治疗难治性高血压

A I Kutsenko, V V Kukharchuk, A V Legkonogov, G G Arabidze, A Iu Zaruba
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引用次数: 0

摘要

研究了58例严重动脉性高血压(AH)患者抗高血压药物治疗难治性,包括受体阻滞剂、钙拮抗剂、抗肾上腺素能药物和利尿剂加用卡托普利和/或米诺地尔。所有患者均进行了3-6次血浆置换(PA),每1次血浆置换高达30 ml/kg体重。血浆置换疗程后血压平均下降24%,部分患者抗高血压药物敏感性恢复,恶性AH症状消除。PA在AH合并慢性肾功能衰竭的患者中效果不佳。治疗后持续血压下降可能是由于激素阳性变化、肾功能改善、靶器官组织受体对降压药的敏感性增加以及外周血循环改善所致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Treatment of refractory arterial hypertension by plasmapheresis].

58 patients with severe arterial hypertension (AH) refractory to antihypertensive drug therapy including beta-blockers, calcium antagonists, antiadrenergic drugs and diuretics with addition of captopril and/or minoxidil were studied. In all the patients 3-6 sessions of plasmapheresis (PA) with plasma exchange up to 30 ml/kg body weight per 1 session were performed. After the course of plasmapheresis BP depression on the average by 24% as well as restoration of sensitivity to antihypertensive drugs and elimination of signs of malignant AH in certain cases were observed. PA was not enough effective in patients with AH combined with signs of chronic renal failure. Persistent BP depression as a result of the treatment is probably caused by positive hormonal changes, improved renal function, increased sensitivity of tissue receptors of target organs to antihypertensive drugs as well as improved peripheral blood circulation.

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