诊断学理论与实践 ›› 2020, Vol. 19 ›› Issue (05): 460-468.doi: 10.16150/j.1671-2870.2020.05.004
陈施吾1a, 窦荣花2, 王玉凯3, 王含4, 王晓平5, 陈先文6, 陈玲7, 王训8, 屈洪党9, 陈生弟1a, Susan Fox10, 李燕1b, 王刚1a(
)
收稿日期:2020-02-28
出版日期:2020-10-25
发布日期:2022-07-14
通讯作者:
王刚
E-mail:wg11424@rjh.com.cn
Received:2020-02-28
Online:2020-10-25
Published:2022-07-14
中图分类号:
陈施吾, 窦荣花, 王玉凯, 王含, 王晓平, 陈先文, 陈玲, 王训, 屈洪党, 陈生弟, Susan Fox, 李燕, 王刚. 帕金森病血压管理专家共识[J]. 诊断学理论与实践, 2020, 19(05): 460-468.
表1
PD患者OH的药物治疗推荐
| 药物类别 | 药物名称 | 治疗效果 | 证据类别 | 推荐级别 | 不良反应 |
|---|---|---|---|---|---|
| 糖皮质激素 | 氟氢可的松 | 可能获益,但很可能有害[ | Ⅲ | B | 加重SH,降低血钾水平 |
| α1受体激动剂 | 米多君 | 很可能获益,1项随机双盲临床试验[ 签随机试验[ | Ⅰ | B | 竖毛反应、尿潴留和SH |
| 去甲肾上腺素前体 药物 | 屈昔多巴 | 高度可能获益,2项随机双盲临床试验[ | Ⅰ | A | SH、幻觉、头痛和恶心 |
| 选择性去甲肾上腺 素重摄取抑制剂 | 托莫西汀 | 很可能获益,1 项病例报告[ | Ⅰ | B | 心动过速、便秘、恶心、 呕吐和肝损伤 |
| 胆碱酯酶抑制剂 | 溴吡斯的明 | 可能获益, 1项随机双盲临床试验[ 试验[ | Ⅱa | B | 腹泻、恶心、呕吐、胃痉 挛、出汗和泌涎增多 |
| 中药 | 升压汤 | 可能获益,无随机双盲临床试验 | Ⅱb | C | 未见报道 |
| 生脉饮 | 可能获益,无随机双盲临床试验 | Ⅱb | C | 未见报道 | |
| 黄芪口服液 | 可能获益,无随机双盲临床试验 | Ⅱb | C | 未见报道 |
表2
PD患者SH的药物治疗推荐
| 药物类别 | 药物名称 | 治疗效果 | 证据类别 | 推荐级别 | 不良反应 |
|---|---|---|---|---|---|
| ACEI | 卡托普利 | 可能获益,无随机双盲临床试验 | Ⅱa | C | 头痛、腹泻、恶心和皮疹 |
| ARB | 氯沙坦 | 很可能获益,1项随机双盲临床试验[ | Ⅰ | B | 头痛、血管性水肿、高钾血症和贫血 |
| 中枢性降压药 | 可乐定 | 可能获益,无随机双盲临床试验 | Ⅱa | C | 淡漠、头晕、抑郁、便秘、恶心、呕吐及失眠 |
| β受体拮抗剂 | 奈必洛尔 | 很可能获益,1项随机双盲临床试验[ | Ⅰ | B | 未见报道 |
| 选择性盐皮质激 素受体拮抗剂 | 依普利酮 | 可能获益,无随机双盲临床试验 | Ⅱb | C | 高钾血症 |
表3
PD患者PPH的药物治疗推荐
| 药物类别 | 药物名称 | 治疗效果 | 证据类别 | 推荐级别 | 不良反应 |
|---|---|---|---|---|---|
| α葡萄糖苷酶抑制剂 | 阿卡波糖 | 很可能获益,1项随机双盲临床试验[ | Ⅰ | B | 腹胀、腹泻和胃肠积气 |
| 伏格列波糖 | 可能获益,无随机双盲临床试验,1项临 床对照试验[ | Ⅱa | C | 低血糖、腹胀、腹泻和头痛 | |
| 生长抑素类似物 | 奥曲肽 | 可能获益,无随机双盲临床试验 | Ⅱa | C | 腹泻、腹痛、头痛、恶心和呕吐 |
图1
PD患者血压异常的处理流程
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