高血压合理用药指南课件

This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压合理用药指南高血压合理用药指南高血压合理用药指南1This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.主要内容主要内容n n高血压流行及治疗现状n n高血压药物分类n n用药原则及规范n n高血压特殊合并症药物治疗原则n n常见特殊类型高血压治疗原则及药物选择n n基层高血压国家基本药物应用原则主要内容高血压流行及治疗现状2This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.流行及治疗现状流行及治疗现状n n2012年，心血管病死亡1700人，高血压并发症死亡占940万n n2010-2040年，每年如果降低心血管病死亡1%，相当于每年创造2010年国内生产总值15%经济收益（2.34万亿美元）流行及治疗现状2012年，心血管病死亡1700人，高血压并发3This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.流行及治疗现状流行及治疗现状 知晓率知晓率知晓率知晓率 治疗率治疗率治疗率治疗率 控制率控制率控制率控制率20022002中国中国30.2%30.2%24.7%24.7%6.1%6.1%2010-20122010-2012中国中国46.5%46.5%41.1%41.1%13.8%13.8%2011-20122011-2012美国美国82.7%82.7%75.6%75.6%51.8%51.8%流行及治疗现状 知晓率 治疗率 控制率4This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.基层高血压用药现状基层高血压用药现状基层高血压用药现状5This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.基层高血压用药现状基层高血压用药现状n n联合用药情况基层高血压用药现状联合用药情况6This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压等级医院药物治疗现状高血压等级医院药物治疗现状n n高血压合并高脂血症及糖代谢异常23.6%n n4.5%患者10年缺血事件风险高于20%n n医保患者血压控制率达53.9%n n联合治疗仅23%n n低中危16%，高危48%，极高危36%n n50%靶器官损伤，49%伴高血压相关疾病高血压等级医院药物治疗现状高血压合并高脂血症及糖代谢异常237This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压药物分类高血压药物分类n n利尿剂高血压药物分类利尿剂8This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压合理用药指南课件9This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压药物分类高血压药物分类n n肾素-血管紧张素-醛固酮系统抑制剂n nACEI：降低循环中的血管紧张素水平，消除其直接缩血管作用，抑制缓激肽降解，促进Ang1-7产生。n nARB：阻断ACE和其他旁路途径参与生成Ang 与Ang 型受体结合发挥降压作用。高血压药物分类肾素-血管紧张素-醛固酮系统抑制剂10This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压药物分类高血压药物分类n n钙拮抗剂（CCB）特点特点特点特点二氢吡啶类二氢吡啶类作用于血管平滑肌作用于血管平滑肌L L型钙通道型钙通道非二氢吡啶类非二氢吡啶类对窦房结和房室结处的钙通道具有选对窦房结和房室结处的钙通道具有选择性，扩血管强度弱于二氢吡啶类，择性，扩血管强度弱于二氢吡啶类，但负性变时、降低交感神经活性是二但负性变时、降低交感神经活性是二氢吡啶类不具备氢吡啶类不具备高血压药物分类钙拮抗剂（CCB）特点二氢吡啶类作用于血管平滑11This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.n n肾上腺素能受体阻滞剂种类种类种类种类特点特点特点特点倍他受体阻滞倍他受体阻滞剂剂非选择性倍他受体阻滞剂非选择性倍他受体阻滞剂降低心输出量、减少肾素释放、减少降低心输出量、减少肾素释放、减少中枢交感神经冲动中枢交感神经冲动选择性选择性11受体阻滞剂受体阻滞剂兼具兼具a1a1和和 受体阻滞受体阻滞a1a1受体阻滞剂受体阻滞剂选择性阻滞儿茶酚胺与突触后选择性阻滞儿茶酚胺与突触后a1a1受体受体结合，扩张血管产生降压效应。结合，扩张血管产生降压效应。交感神经抑制交感神经抑制剂剂中枢性降压药（可乐定，甲基中枢性降压药（可乐定，甲基多巴）多巴）激活延脑中枢激活延脑中枢a2a2受体，抑制中枢神经受体，抑制中枢神经系统释放交感神经冲动而降压，因降系统释放交感神经冲动而降压，因降低压力感受器的活性可出行直立性低低压力感受器的活性可出行直立性低血压血压交感神经末梢抑制剂（利血平）交感神经末梢抑制剂（利血平）阻断去甲肾上腺素向其储存囊泡的转阻断去甲肾上腺素向其储存囊泡的转运，减少交感冲动，降低外周阻力，运，减少交感冲动，降低外周阻力，消耗儿茶酚胺消耗儿茶酚胺肾上腺素能受体阻滞剂种类特点倍他受体阻滞剂非选择性倍他受体阻12This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压药物分类高血压药物分类n n交感神经抑制剂种类种类种类种类特点特点特点特点中枢性降压药（可乐定，甲基多巴）中枢性降压药（可乐定，甲基多巴）激活延脑中枢激活延脑中枢a2a2受体，抑制中枢神经受体，抑制中枢神经系统释放交感神经冲动而降压，因降系统释放交感神经冲动而降压，因降低压力感受器的活性可出行直立性低低压力感受器的活性可出行直立性低血压血压交感神经末梢抑制剂（利血平）交感神经末梢抑制剂（利血平）阻断去甲肾上腺素向其储存囊泡的转阻断去甲肾上腺素向其储存囊泡的转运，减少交感冲动，降低外周阻力，运，减少交感冲动，降低外周阻力，消耗儿茶酚胺消耗儿茶酚胺高血压药物分类交感神经抑制剂种类特点中枢性降压药（可乐定，甲13This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压药物分类高血压药物分类n n直接血管扩张剂（肼屈嗪）直接扩张小动脉，降低外周阻力，增加心输出量及肾血流量，但有反射性交感神经活性激活作用。高血压药物分类直接血管扩张剂（肼屈嗪）14This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.降压药物用药原则及规范降压药物用药原则及规范n n利尿剂利尿剂n n特点：适用于绝大多数无禁忌症的高血压患者初始和维特点：适用于绝大多数无禁忌症的高血压患者初始和维持治疗，尤其适合老年高血压、难治性高血压、心力衰持治疗，尤其适合老年高血压、难治性高血压、心力衰竭高血压、盐敏感性高血压。竭高血压、盐敏感性高血压。n n老年高血压证据：老年高血压证据：SHEPSHEP试验结果，氯噻酮显著降低卒试验结果，氯噻酮显著降低卒中、非致死性心力衰竭和心肌梗死发生率。中、非致死性心力衰竭和心肌梗死发生率。HYVETHYVET试试验发现：验发现：8080岁以上接受吲达帕胺必要时家用培哚普利显岁以上接受吲达帕胺必要时家用培哚普利显著降低全因死亡率和致死性卒中发生率。著降低全因死亡率和致死性卒中发生率。n n难治性高血压证据：难治性高血压证据：ASCOT-BPLAASCOT-BPLA为在高血压且至少为在高血压且至少3 3危险因素患者中发现，在已有三种降压药物基础上，加危险因素患者中发现，在已有三种降压药物基础上，加用螺内酯后血压降低用螺内酯后血压降低21.9/9.5mmHg21.9/9.5mmHg。显著提高达标率。显著提高达标率。降压药物用药原则及规范利尿剂15This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.利尿剂利尿剂高血压合并心力衰竭证据：袢利尿剂和噻嗪类具有利尿排钠作用。各国指南均推荐为首选。高盐摄入人群高血压：我国人群50-60%为盐敏感者。此类患者利尿剂和CCB首选。特别是盐摄入12g/日以上者。低肾素型、黑人高血压、肥胖者高血压均具有良好效果。利尿剂高血压合并心力衰竭证据：袢利尿剂和噻嗪类具有利尿排钠16This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.利尿剂利尿剂n n禁忌症：痛风禁用噻嗪类 高钾与肾衰禁用醛固酮拮抗剂注意：长期应用导致电解质紊乱、糖代谢异常、高尿酸血症、体位性低血压等。联合方案：小剂量噻嗪类联合ACEI,ARB,CCB较足量单药效果好，副作用少。与阻滞剂联合可增加部分新发糖尿病风险。应用噻嗪类初始2-4周观察低血钾有无，后每年1-2次。高尿酸不是禁忌，但避免应用。利尿剂禁忌症：痛风禁用噻嗪类17This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.利尿剂利尿剂通用名通用名通用名通用名持续时间（小时）持续时间（小时）持续时间（小时）持续时间（小时）半衰期（小时）半衰期（小时）半衰期（小时）半衰期（小时）常用剂量（常用剂量（常用剂量（常用剂量（mgmg）氢氯噻嗪氢氯噻嗪16-2416-249-109-1012.5-2512.5-25，qdqd苄氟噻嗪苄氟噻嗪12-1812-189 95-155-15，qdqd氯噻酮氯噻酮48-7248-7250-6050-6025-10025-100，qdqd吲达帕胺吲达帕胺242418181.25-2.51.25-2.5，qdqd阿米洛利阿米洛利6-106-106-96-95-105-10，qdqd螺内酯螺内酯12-9612-9613-2413-2410-4010-40，qdqd利尿剂通用名持续时间（小时）半衰期（小时）常用剂量（mg）氢18This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.钙拮抗剂钙拮抗剂二氢吡啶类：作用于动脉非二氢吡啶类：如苯烷胺类（维拉帕米）苯噻嗪类（地尔硫卓）作用于心脏。包括负性变时，负性传导，负性变力。n n适应症：容量性高血压如老年高血压、单纯收缩期高血压、低肾素活性高血压、低交感活性高血压。不受高盐摄入影响。钙拮抗剂二氢吡啶类：作用于动脉19This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.钙拮抗剂适应症钙拮抗剂适应症n n合并动脉粥样硬化高血压：多项研究证明CCB降压同时能延缓动脉硬化的进展。如ELSA研究发现拉西地平逆转颈动脉内中膜厚度。INSGHT显示硝苯地平控释片与利尿剂比较均可明显改善内膜厚度。n n非二氢吡啶类：更适用于合并心绞痛、室上性心动过速及动脉硬化者。钙拮抗剂适应症合并动脉粥样硬化高血压：多项研究证明CCB降压20This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.钙拮抗剂禁忌症钙拮抗剂禁忌症n n只有相对禁忌症，无绝对禁忌症禁忌症禁忌症禁忌症禁忌症二氢吡啶类二氢吡啶类短中效短中效CCBCCB降压同时出现反射性心动过降压同时出现反射性心动过速，相对禁用于合并快速心律失常者速，相对禁用于合并快速心律失常者非二氢吡啶类非二氢吡啶类禁用于二度以上房室传导阻滞，心力衰禁用于二度以上房室传导阻滞，心力衰竭者竭者钙拮抗剂禁忌症只有相对禁忌症，无绝对禁忌症禁忌症二氢吡啶类短21This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.钙拮抗剂注意事项钙拮抗剂注意事项1、CCB扩血管降压易出现反射性心动过速，尽量应用长效制剂。2、CCB中如硝苯地平、维拉帕米、地尔硫卓有明显负性肌力作用，避免应用于左室收缩功能不全者。3、非二氢吡啶类CCB负性传导作用，传导功能障碍者慎用。避免和阻滞剂何用。钙拮抗剂注意事项1、CCB扩血管降压易出现反射性心动过速，尽22This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.CCB单药与联合方案推荐单药与联合方案推荐n n几乎适用所有高血压。n n对代谢无不良影响，更适用于糖尿病和代谢综合征者。n nCCB联合ARB（ACOMPLISH证实）n nCCB联合ACEI（ASCOT证实）n nCCB联合噻嗪类利尿剂（FEVER证实）n nCCB联合阻滞剂（HOT,INSIGHT证实）CCB单药与联合方案推荐几乎适用所有高血压。23This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压合理用药指南课件24This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.血管紧张素受体阻断剂（血管紧张素受体阻断剂（ARB）血管紧张素受体阻断剂（ARB）25This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ARB用药原则用药原则n n属剂量依赖性，不良反应也随剂量增加而增加。n n除降压外，还有心血管、肾脏保护及改善糖代谢作用，优先用于合并左室肥厚、心力衰竭、心房颤动、冠心病、糖尿病肾病、微量蛋白尿、代谢综合征及不耐受ACEI者。ARB用药原则属剂量依赖性，不良反应也随剂量增加而增加。26This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ARB禁忌症禁忌症n n致畸，禁用于妊娠。n n致GFR下降，肌酐升高、血钾升高。n n双侧肾动脉狭窄禁用。ARB禁忌症致畸，禁用于妊娠。27This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ARB应用注意事项应用注意事项n n对CKD4-5期患者，初始剂量减半并严密观察钾、肌酐及GFR变化，肌酐超过3mg/dl慎用。n n单侧肾动脉狭窄应注意观察健侧肾功能。n nACS或合并心力衰竭，小剂量开始应用。n n高钾或肾损伤者，避免联合ACEI+ARB,或+盐皮质激素受体拮抗剂。n n极少数者出现咳嗽。ARB应用注意事项对CKD4-5期患者，初始剂量减半并严密观28This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ARB单药及联合方案推荐单药及联合方案推荐n n单药可降低1-2级高血压，平均降压10/5mmHg。剂量翻倍，继续下降30%左右。4周不达标，可增加至足量或联合用药。n n2级以上高血压，初始联合（利尿剂或CCB），4周不达标可加大剂量，或三药联合。4周仍未达标，考虑转诊高血压门诊，排除其他因素导致高血压如白大衣效应。必要时调整用药时间或加用其他种类降压药。ARB单药及联合方案推荐单药可降低1-2级高血压，平均降压129This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ARB联合选择联合选择n nARB+利尿剂：盐敏感性高血压、老年高血压、合并糖尿病、心力衰竭、肥胖等。n nARB+CCB：老年高血压、合并糖尿病、冠心病、CKD、外周血管病。n n目前不推荐ARB+阻滞剂，避免ARB+ACEI联合。ARB联合选择ARB+利尿剂：盐敏感性高血压、老年高血压、合30This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.常用常用ARB单药应用单药应用常用ARB单药应用31This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.血管紧张素转化酶抑制剂血管紧张素转化酶抑制剂（ACEI)n n特点：通过竞争性地抑制ACE发挥降压作用。大量询证证据该类药对于高血压者具有良好的靶器官保护和心血管终点事件预防作用。成为高血压治疗基石之一。n n根据结合基团分为：巯基类（卡托普利）、羧基类（依那普利）、磷酸基类（福辛普利）。羧基类较好组织亲和力。更好对不同组织的ACE抑制。血管紧张素转化酶抑制剂（ACEI)特点：通过竞争性地抑制AC32This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.血管紧张素转化酶抑制剂血管紧张素转化酶抑制剂（ACEI)n n根据代谢途径分为：经肝脏与肾脏双途径排泄（福辛普利、群多普利、佐芬普利、螺普利）；经肾脏排泄（其余ACEI）。n n根据药物活性分为：前体药物（福辛普利）、非前体药物（卡托普利），前体药物亲脂性更高，更容易进入组织转化为活性药物。血管紧张素转化酶抑制剂（ACEI)根据代谢途径分为：经肝脏与33This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ACEI用药原则用药原则n n合并左室肥厚及既往心肌梗死者，通过降低前后负荷，抑制Ang和交感神经活性等逆转心室重构，并可轻度逆转心肌肥厚改善舒张功能。n n合并左室功能不全者，减轻心脏后负荷，抑制RASS活性，降低心衰者病死率及复发心肌梗死风险。n n合并代谢综合征、糖尿病肾病、蛋白尿及微量蛋白尿者：能够降低肾血管阻力增加肾血流量。n n合并ASCVD者可延缓粥样硬化进展。ACEI用药原则合并左室肥厚及既往心肌梗死者，通过降低前后负34This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ACEI禁忌症禁忌症绝对禁忌症绝对禁忌症绝对禁忌症绝对禁忌症育龄、产妇、计划怀孕避免育龄、产妇、计划怀孕避免育龄、产妇、计划怀孕避免育龄、产妇、计划怀孕避免血管神经性水肿血管神经性水肿血管神经性水肿血管神经性水肿双侧肾动脉狭窄双侧肾动脉狭窄双侧肾动脉狭窄双侧肾动脉狭窄高钾血症高钾血症高钾血症高钾血症相对禁忌症相对禁忌症肌酐大于肌酐大于265ummol/l265ummol/l钾钾5.5mmol/l5.5mmol/l有症状的低血压有症状的低血压有妊娠可能的女性有妊娠可能的女性左室流出道梗阻左室流出道梗阻ACEI禁忌症绝对禁忌症育龄、产妇、计划怀孕避免相对禁忌症35This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ACEI注意事项注意事项n n尽量选择长效，避免合用影响降压效果药物如大部分非甾体抗炎药（阿司匹林300mg）、激素。n n治疗前检测钾、肌酐、GFR。小剂量开始，逐渐上调剂量。2-4周复查血钾及肌酐。如发现钾超过5.5mmol/l或肌酐增高30%，减量继续监测，必要时停药。n n干咳和低血压应积极调整，避免依从性下降。n n单药效果不佳，可考虑联合。ACEI注意事项尽量选择长效，避免合用影响降压效果药物如大部36This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ACEI联合用药联合用药n n联合噻嗪类利尿剂：噻嗪类可引起血容量不足导致RASS激活，ACEI抑制RASS加强降压效应并避免低血钾。n n联合CCB：CCB直接扩张动脉并反射引起RASS激活，ACEI可扩张动静脉并抑制RASS，抵消CCB产生的水肿。ACEI联合用药联合噻嗪类利尿剂：噻嗪类可引起血容量不足导致37This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ACEI单药应用单药应用ACEI单药应用38This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.受体阻滞剂受体阻滞剂受体阻滞剂39This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.受体阻滞剂分类受体阻滞剂分类种类种类种类种类特点特点特点特点非选择性非选择性 受体阻滞剂受体阻滞剂竞争性阻断竞争性阻断 1 1受体和受体和 2 2受体受体，导致糖脂代谢导致糖脂代谢和肺功能不良影响；阻断血管上和肺功能不良影响；阻断血管上22受体相受体相对兴奋对兴奋a a受体增加周围血管阻力。如心得安。受体增加周围血管阻力。如心得安。选择性选择性 1 1受体阻滞剂受体阻滞剂选择性阻断选择性阻断11受体，对受体，对22影响较小。如美托影响较小。如美托洛尔和比索洛尔。洛尔和比索洛尔。有周围血管舒张功能的有周围血管舒张功能的 受体阻滞受体阻滞剂剂通过阻断通过阻断a1a1受体，产生周围血管舒张作用如受体，产生周围血管舒张作用如卡维地洛、阿罗洛尔、拉贝洛尔等。卡维地洛、阿罗洛尔、拉贝洛尔等。受体阻滞剂分类种类特点非选择性受体阻滞剂竞争性阻断1受40This paper mainly introduces the design of an intelligent temperature control system which realizes the fu