中国实用内科杂志

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高血压肾损害诊治新认识

蔡广研寇佳陈香美   

  1. 作者单位:解放军总医院肾脏病科 全军肾脏病研究所,北京 100853
  • 出版日期:2013-03-01 发布日期:2013-03-04
  • 作者简介:蔡广研,主任医师、教授、博士生导师。解放军总医院肾脏病科副主任、全军肾脏病研究所副所长。兼任中华医学会肾脏病学分会副主任委员、解放军肾脏病学专业委员会副主任委员、中国肾脏内科医师协会常务委员、卫生部临床路径技术审核专家;担任《中华肾脏病杂志》副主编及《中华医学杂志英文版》、《中国实用内科杂志》等期刊编委或通讯编委。荣获“求是”杰出青年奖、中国青年科技奖、军队创新人才工程“学科拔尖人才培养对象”、总后科技新星与北京市科技新星等荣誉。

New concepts for diagnosis and treatment of hypertensive nephropathy.

CAI Guang-yanKOU JiaCHEN Xiang-mei.   

  1. Department of Nephrology,Kidney Research Institute of Chinese Peoples Liberation Army,State Key Laboratory of Kidney Diseases,Chinese PLA General Hospital,Beijing 100853,China
  • Online:2013-03-01 Published:2013-03-04

摘要:

高血压肾损害是由于长期血压增高引起肾内小动脉及细小动脉病变,导致肾脏缺血性改变的一组临床综合征,是终末期肾脏疾病(ESRD)的重要病因。高血压肾损害的临床及病理表现缺少特征性改变。因此,临床诊断需要仔细鉴别以除外其他肾脏疾病。近年来反映肾小管功能指标、微量白蛋白尿、肾小球高滤过等成为新的诊断指标。确定降压目标值应考虑患者年龄、蛋白尿及肾功能水平。以肾素-血管紧张素系统(RAS)阻断剂为基础进行联合降压治疗,纠正代谢异常、调整生活方式等综合措施,有利于改善肾脏远期预后,并减少心脑血管并发症。

关键词: 高血压, 肾疾病, 终末期肾脏疾病

Abstract:

Abstract:Hypertensive nephropathy,the syndrome clinically resulting from intrarenal arteriolar and small arterial lesion leading to renal ischemia,has been the critical cause for end-stage renal disease (ESRD).Differential diagnosis of miscellaneous renal diseases is necessary inasmuch that hypertensive nephropathy lacks typical clinical and pathological changes.The diagnostic indices reflecting the renal tubular function,microalbuminuria and glomerular hyperfiltration have been available.Goal based on Patient age,level of proteinuria and renal function should be determined for establishing an antihypertensive target.Renin-angiotensin system antagonist for combined antihypertensive treatment,on the basis of integrated approaches for correcting metabolic disorders and adjustment of life style,may improve the long-term prognosis and reduce the complications of cardiovascular systems.

Key words: hypertension, kidney disease, end stage renal diseases

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