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婴儿高血压的治疗

Author
Joseph T Flynn, MD, MS
Section Editor
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD
Translators
杨杰, 主任医师，教授

引言

对于新生儿这一年龄组，由于缺乏关于长期结局的证据，以及缺乏评估抗高血压药物安全性和有效性的临床试验，新生儿高血压的最佳治疗方案仍未确定。因此，治疗推荐通常依据基于临床经验和判断的专家意见。

本专题将总结婴儿高血压的治疗，包括开始药物治疗的建议方法。新生儿和年龄较大婴儿高血压的病因、评估和诊断将单独讨论。 (参见“新生儿高血压的病因、临床特征及诊断”和“1月龄至1岁婴儿的高血压”)

概述

尽管有关婴儿高血压治疗的数据有限，但除了非药物治疗外，其他治疗方法与年龄较大儿童的治疗相似，非药物治疗对年龄较大儿童很重要但对婴儿没有作用或作用非常有限。决策取决于高血压的严重程度、基础病因和其他影响患儿健康的临床因素。

治疗包括识别和纠正任何可治愈的高血压病因，并且有需要时，开始药物治疗以降低血压。

然而，由于缺乏长期结局数据，婴儿开始抗高血压治疗的临床标准尚未充分确定[即血压(blood pressure, BP)阈值]。因此，开始抗高血压治疗的指征主要依据专家的临床意见[1]。另外，有关控制婴儿高血压的特定药物使用的信息有限，大部分资料来源于对新生儿的小型观察性病例系列研究[2-7]。因此，大部分关于药物干预的治疗决策是经验性的，要依靠临床经验和判断。在婴儿开始抗高血压药物治疗之前，推荐与儿科肾病学家和/或其他有治疗婴儿高血压经验的临床医生进行会诊。

                    

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Literature review current through: 2017-06 . | This topic last updated: 2015-08-18.
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