Journal of Diagnostics Concepts & Practice ›› 2020, Vol. 19 ›› Issue (05): 454-459.doi: 10.16150/j.1671-2870.2020.05.003
• Guideline and consensus • Previous Articles Next Articles
Received:2020-07-20
Online:2020-10-25
Published:2022-07-14
CLC Number:
| 药物类别 | 药物名称 | 筛查前停药时间（周） |
|---|---|---|
| 利尿剂 | 螺内酯、依普利酮等醛固酮受体拮抗剂,阿米洛利、氨苯蝶啶等保钾利尿剂, 氢氯噻嗪、吲达帕胺、呋塞米、托拉塞米等排钾利尿剂 | 4 |
| 甘草及其提取物 | 天晴甘美、甘草口服液 | 4 |
| 血管紧张素转换酶抑制剂 | 卡托普利、依那普利、贝那普利、培哚普利、赖诺普利等 | 2 |
| 血管紧张素受体拮抗剂 | 氯沙坦、缬沙坦、厄贝沙坦、替米沙坦、坎地沙坦、奥美沙坦、阿利沙坦等 | 2 |
| 二氢吡啶类钙通道阻滞剂 | 硝苯地平、氨氯地平、非洛地平等 | 2 |
| 肾上腺素β受体阻滞剂 | 美托洛尔、比索洛尔、阿替洛尔、阿罗洛尔等 | 2 |
| 中枢α2受体激动剂 | 可乐定、甲基多巴等 | 2 |
| 非甾体抗炎药 | 吲哚美辛、双氯芬酸、布洛芬等 | 2 |
| 药物类别 | 药物名称 | 常用剂量 | 注意事项 |
|---|---|---|---|
| 非二氢吡啶类钙通道阻滞剂 | 维拉帕米缓释片 | 120~240 mg（qd或bid） | 可单用,或与此表中其他种类药物联合 |
| 地尔硫?缓释制剂 | 90 mg（qd或bid） | ||
| 肾上腺素α受体阻滞剂 | 多沙唑嗪 | 4 mg（qd）,根据需要加量 | 注意直立性低血压 |
| 特拉唑嗪 | 2 mg（qd）,根据需要加量 | ||
| 哌唑嗪 | 1 mg（bid或tid）,根据需要加量 | ||
| 血管扩张剂 | 肼屈嗪 | 10 mg（qid）,根据需要加量 | 小剂量开始,减少头痛、面红、心悸等不良反应 |
| 试验名称 | 试验方法 | 结果判断 |
|---|---|---|
| 静脉生理盐水滴注试验 | 试验前,卧床休息1 h,4 h内静脉滴注生理盐水2 L。通常试验在 早上8点至9点间开始,整个过程中监测血压和心率变化。输注前及输注后,分别采集血液标本,检测血浆肾素活性或浓度及醛固酮、皮质醇以及血清钾水平 | 试验后,血浆醛固酮>100 ng/L时,确诊为原醛;<50 ng/L,排除原醛 |
| 卡托普利试验 | 坐位或立位1 h后,口服50 mg卡托普利,服药之前以及服药后1 h、2 h,分别测定血浆肾素活性或浓度及醛固酮、皮质醇水平,试验期间患者始终保持坐位 | 正常人,卡托普利抑制试验后,血浆醛固酮浓度下降大于30%,而原醛患者,血醛固酮不受抑制 |
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