
[内科] 惡性高血壓
Thickening of the arterial wall with malignant hypertension also produces a hyperplastic arteriolitis .
惡性高血壓的動脈管壁增厚形成了結節性多動脈炎。
Malignant hypertension, a severe, rapidly progressing form, requires emergency treatment with drugs to dilate the Blood vessels.
惡性高血壓是嚴重快速發展的形式,須用藥物擴大血管的緊急治療。
Objective To investigate the incidence, clinical characteristics and prognosis of malignant hypertension (MHT) resulted from renal artery stenosis (RAS).
目的了解腎動脈狹窄(RAS)所緻惡性高血壓(MHT)的發病情況、臨床特點和預後。
Malignant hypertension leads to fibrinoid necrosis of small arteries as shown here. The damage to the arteries leads to formation of pink fibrin--hence the term fibrinoid.
惡性高血壓導緻小動脈纖維素樣壞死。動脈損傷引起粉紅色纖維素壞死物形成,因此稱為纖維素樣壞死。
Objective To find out the clinical features and pathological characteristics of malignant hypertension(MHT) with renal damage.
目的觀察惡性高血壓的臨床表現和腎髒病理特點,以增進對惡性高血壓腎損害的認識。
One complication of hyperplastic arteriolosclerosis with malignant hypertension is fibrinoid necrosis, as seen here in a renal arteriole.
腎髒增生性細動脈硬化合并高血壓,如圖發生纖維素樣壞死。
Objective To observe the effect of treatment with Urapidil and Sodium nitroprusside in malignant hypertension patients.
目的觀察烏拉地爾、硝普鈉治療惡性高血壓的降壓效果。
This is a different kind of arteriosclerosis. This is hyperplastic arteriolosclerosis, which most often appears in the kidney in patients with malignant hypertension.
這是另一種類型的動脈硬化的表現,呈增生性細動脈硬化,常見于惡性高血壓引起的腎動脈硬化。
Other underling diseases including hypertension, coronary heart disease and malignant tumor also increased and became new risk factors for PTE.
近年高血壓、冠心病、惡性腫瘤發病率不斷提高,成為PTE的新危險因素。
Incidence rate of hypertension, stroke, CHD. malignant tumor in the aged has been on the increased in recent years, but the mortality rate has decreased.
近年來,老年人高血壓、腦卒中、冠心病、惡性腫瘤發病率逐年上升,而死亡率逐年下降。
Most of the patients belong to non-tuberculosis cause death were following suffer from malignant tumor, renal failure, diabetes and hypertension.
在非結核病導緻死亡的部分,大多個案伴隨罹患惡性腫瘤、腎衰竭、糖尿病與高血壓。
Results Pelvic malignant tumors, old age, blood hyperviscosity, hypertension, diabetes mellitus and application of hemostatic drugs were high risk factors for postoperative DVT.
結果發生DVT的高危因素是盆腔惡性腫瘤、老年婦女、血粘度增高、合并高血壓、糖尿病及術後常規應用止血藥等。
The parameters above measured in different groups including control group, portal hypertension group, choledochus obstruction group, and malignant tumor group were compared.
探讨以上測量數據在正常對照組、門靜脈高壓組、膽管擴張組和惡性腫瘤組之間的差異。
Pheochromocytoma is an important cause of secondary hypertension, whose pathogenesis is yet to be clarified. It is still difficult to identify malignant cases at early stage.
嗜鉻細胞瘤是引起繼發性高血壓的重要原因,其發病機制目前還不完全清楚,臨床上早期鑒别良惡性腫瘤尚有困難。
Thickening of the arterial wall with malignant hypertension also produces a hyperplastic arteriolitis. The arteriole has an onion skin appearance.
惡性高血壓引起的動脈壁增厚發生增生性小動脈炎,小動脈呈洋蔥皮樣表現。
Conclusion Malignant hypertension presenting with renal damage was not very rare. The clinical presentations and prognosis of primary MHT were different from those of renal parenchymal MHT.
結論以腎髒受累為主要表現的惡性高血壓不少見,原發性與腎實質性惡性高血壓的臨床改變及預後均不同。
Malignant hypertension is the most lethal form of hypertension.
惡性高血壓是最容易導緻死亡的一種高血壓。
Malignant hypertension leads to fibrinoid necrosis of small arteries as shown here.
惡性高血壓導緻小動脈纖維素樣壞死。
惡性高血壓(malignant hypertension)是高血壓急症中最嚴重的類型之一,指血壓在短時間内急劇升高(通常收縮壓≥180mmHg和/或舒張壓≥120mmHg),并伴隨急性靶器官損傷的臨床綜合征。該術語在2022年《中國高血壓防治指南》中被歸類為需要立即住院治療的危重病症。
從病理機制來看,惡性高血壓的核心改變是全身小動脈纖維素樣壞死和增生性動脈内膜炎,這種病理過程會導緻腦、心、腎等重要器官的微循環障礙。美國心髒病學會(American College of Cardiology)的專題研究指出,腎素-血管緊張素-醛固酮系統(RAAS)過度激活是主要的驅動因素。
臨床表現具有三聯征特征:
根據《哈裡森内科學》(Harrison's Principles of Internal Medicine)的診療标準,确診需同時滿足: $$
DBP geq 130mmHg quad text{且} quad text{視網膜出血/滲出}
$$
并至少合并以下任一項:急性腎損傷(血肌酐升高≥0.3mg/dL)、急性肺水腫或腦病症狀。
在治療方面,美國心髒協會(American Heart Association)建議采用靜脈降壓藥物(如尼卡地平或艾司洛爾),目标是在2-6小時内将平均動脈壓降低不超過25%,24-48小時内逐步達到安全範圍。
惡性高血壓(malignant hypertension)是一種嚴重且進展迅速的高血壓類型,以下是其詳細解釋:
注:更多專業細節可參考醫學詞典(如、)或病理學資料(如)。
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