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爹爹自服降压药10年出现肾衰竭
2017-08-16 05:47:06 中国青年网
本报讯(记者刘璇 通讯员罗瑶)身患高血压10多年,长期自己到药店买药吃,从来没去医院复诊过。直到近日全身水肿到医院一查,才知已经出现肾衰竭和高钾血症。经过7天的透析治疗,水肿才消。昨天,医生给准备出院的爹爹重新调整了降压药的类型和剂量,并反复叮嘱他定期复诊。
74岁的刘爹爹在10多年前就查出高血压,他懒得往医院跑,就自己到药店买降压药吃。每天一颗,自觉血压控制得还不错,也从来没有去医院复诊过。今年7月,刘爹爹稍微活动一下就胸闷、喘不上气,以为是上了年纪精力不济,休息一下就没事了。没想到一个月过去,症状反而越来越严重,出现全身乏力、水肿的症状,家人吓得赶紧将刘爹爹就近送到武汉市第六医院。
接诊医生仔细询问病情得知,刘爹爹除了高血压之外,还合并糖尿病、冠心病、慢性肾功能不全,这些年只要听人说哪种降压药好,他就去买来吃,一个多月前刚刚新换了一种。检查发现,刘爹爹血钾浓度大大超标,血肌酐是正常值上限的4倍,被确诊为肾衰竭和高钾血症。幸运的是,经过连续7天的透析治疗,各项指标终于恢复正常。
该院心血管内科主任张苏川指出,从刘爹爹的症状来看,很可能是服用了名叫“沙坦”或是“普利”的降压药。他解释说,这两类降压药都有一个副反应就是肾损伤,在使用前必须先查肝肾功能。肾功能不好和双肾血管狭窄的高血压病人在使用时要格外谨慎,必须密切监测肾功能,否则很可能会出现急性肾衰竭和高钾血症。
医生提醒:
武汉市第一医院药学部高血压临床药师叶小春介绍,目前临床上有五大类降压药,不同的人群合适的降压药都有不同,首诊最好在专科医生的指导下,制定规范的降压方案。开始每个月复诊一次,待血压稳定后,半年复诊一次。服药期间,要定期监测肝肾功能。
她提醒,血压忽高忽低经常波动,比持续高血压更危险。在选用降压药时,最好选用长效降压药和缓释剂。
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