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儿童原发性肾病综合征高血压危急症的诊治进展

Progress on diagnosis and treatment of hypertensive emergencies and urgencies with primary nephrotic syndrome in children

摘要肾脏疾病是儿童继发性高血压和高血压危象最常见的病因,可导致严重的心脑血管事件,威胁生命。同时,高血压也是儿童原发性肾病综合征治疗过程中常见的并发症。因此,儿童原发性肾病综合征诊治过程中,需要积极地识别和处理高血压危急症,最大程度地减少高血压导致的靶器官损伤。高血压危象根据有无靶器官损害分为高血压急症和高血压亚急症,一旦发现高血压急症,需立即快速平稳降压,降压目标为最开始6~8 h降低不超过计划血压下降程度的25%,首选降压药物为静脉降压药,后续通常需联合降压治疗。

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abstractsKidney disease is the most common cause of secondary hypertension and hypertensive crisis in children, which can lead to serious cardiovascular and cerebrovascular events and threaten life.Meanwhile, hypertension is also a common complication during the treatment of primary nephrotic syndrome in children.Therefore, during the process of diagnosis and treatment of primary nephrotic syndrome in children, it is necessary to actively identify and manage hypertensive emergencies and urgencies, to minimize the damage of target organs caused by hypertension.Hypertension crisis is divided into hypertensive emergency and hypertensive urgency according to presence or absence of target organ damages.Once the hypertensive emergency is found, blood pressure should be lowered rapidly and stably, and blood pressure should be reduced by no more than 25% of the planned reduction over the first 6-8 hours, and intravenous antihypertensive drugs are the first choices, as well as subsequent combined antihypertensive therapy is usually be used.

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