服用止痛药也能引起血压升高？
<h2 style="font-weight: bold;white-space: normal;line-height: 1.6em;"><br/></h2><p><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-style-id="32687"><section style="margin-top: 10px;margin-right: 6px;margin-bottom: 10px;"><section style="display: inline-block;background-color: rgb(255, 55, 55);border-radius: 6px;box-sizing: border-box;"><section style="padding: 2px 10px;letter-spacing: 2px;color: rgb(254, 254, 254);font-size: 16px;box-sizing: border-box;"><p style="letter-spacing: 1px;">患者资料</p></section></section><section style="margin-top: -20px;margin-left: 6px;box-shadow: rgb(200, 200, 200) 0px 0px 6px;border-radius: 10px;box-sizing: border-box;"><section style="padding: 25px 15px 15px;box-sizing: border-box;"><section style="color: #616161;letter-spacing: 2px;font-size: 14px;line-height: 1.75em;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="line-height: 2.5em;"><span style="font-size: 16px;color: #000000;"> 患者张某，男，68岁，高血压病史10余年，长期服用左旋氨氯地平片2.5mg 和依拉普利片10mg 每日一次，血压一直控制良好，均值在125/80mmHg左右。近1个月来血压出现波动性上升遂就诊。</span></p><p style="line-height: 2.5em;"><span style="font-size: 16px;color: #000000;"> 仔细询问患者作息时间、饮食习惯、运动及服药方式、服药时间等均没有大的变化，再追问是否服用其他药物时患者表示约3个月前因膝关节疼痛开始每日服用莱普生止痛。体查：BP 140/86mmHg。</span></p><p style="line-height: 2.5em;"><span style="color: #000000;"><strong><span style="font-size: 16px;"> 处方</span></strong><span style="font-size: 16px;">：继续原降压方案，停用萘普生，建议骨科就诊更换止痛药物或采取其他治疗方式。</span></span></p><p style="line-height: 2.5em;"><span style="color: #000000;"><strong><span style="font-size: 16px;"> 随访</span></strong><span style="font-size: 16px;">：1月后门诊再次就诊，血压逐渐平稳恢复至以前水平。</span></span></p><p style="line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);"> </span><span style="color: rgb(0, 0, 0);font-size: 16px;"> <strong>分析血压升高原因</strong>：服用萘普</span><span style="color: rgb(0, 0, 0);font-size: 16px;">生导致血压波动升高。</span></p></section></section></section></section></section><section data-support="96编辑器" data-style-id="33040"><section><section><section><section><section><section data-support="96编辑器" data-style-id="33040"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-width: 1px;border-style: dashed;border-color: rgb(255, 0, 0);box-sizing: border-box;"><section style="width:50%;height:16px;margin-left:auto;background-color:#fff6f5;" data-width="50%"><br/></section><section style="display: flex;justify-content:center;align-items:flex-start;"><section style="width:97%;display: flex;justify-content:center;align-items:flex-end;" data-width="97%"><section style="width:16px;height:100px;background-color:#fff6f5;"><br/></section><section style="width: 97%;margin-right: auto;margin-left: auto;" data-width="97%"></section></section><section style="width:16px;height:100px;background-color:#fff6f5;"><br/></section></section><section style="width:50%;height:16px;background-color:#fff6f5;" data-width="50%"><br/></section></section></section></section></section></section></section></section></section></section></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);"> 莱普生是一种非甾体抗炎药。它是怎么样引起血压升高的呢？</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><p><section style="white-space: normal;"><section><section><section><section><section><section><section data-support="96编辑器" data-style-id="12554"><section><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 247, 247);border-radius: 5px;box-sizing: border-box;"><section style="padding: 10px;background-color: rgb(255, 247, 247);border-radius: 5px;box-sizing: border-box;"><section style="padding: 10px 8px 6px;box-sizing: border-box;"><section style="color: rgb(0, 0, 0);letter-spacing: 0px;line-height: 20px;"><p style="line-height: 2em;letter-spacing: 1px;"><span style="font-size: 16px;"> 人体内前列腺素E、前列腺素F能够使血管平滑肌松弛，减少外周阻力，从而降低血压。非甾体抗炎药可抑制前列腺素内氧化酶还原酶活性，使前列腺素I2和前列腺素E2的合成和释放减少，进而抑制前列腺素直接扩张血管的作用，促进近段肾小管的钠重吸收，导致水钠储溜和血管收缩。同时，非甾体抗炎药对β受体阻滞剂的影响较大，它通过下调血浆基础肾素的活性，从而使β受体阻滞剂无法发挥活性进而影响β受体阻滞剂降压的药效。</span></p></section></section></section></section></section></section></section></section></section></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><p><section style="white-space: normal;"><section><section><section><section><section><section><section data-support="96编辑器" data-style-id="12554"><section><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 247, 247);border-radius: 5px;box-sizing: border-box;"><section style="padding: 10px;background-color: rgb(255, 247, 247);border-radius: 5px;box-sizing: border-box;"><section style="padding: 10px 8px 6px;box-sizing: border-box;"><section style="color: rgb(0, 0, 0);letter-spacing: 0px;line-height: 20px;"><p style="line-height: 2em;letter-spacing: 1px;"><span style="font-size: 16px;"><span style="color: rgb(255, 76, 65);"> 非甾体抗炎药物对血压正常人群的影响比较小</span>，其引起血压显著升高的人群多见于服用非甾体抗炎药物的高血压患者，多见于老年高血压者、糖尿病者及肾功能不全者等。但是需要注意的是不同的非甾体抗炎类药物对血压的影响存在一定的差异，其中吲哚美辛、萘普生对于血压影响幅度较大，罗非昔布引起血压升高现象最为明显，其中使用萘普生的患者平均动脉压上升3.74mmHg。但是阿司匹林、布洛芬对血压影响幅度较小，因此联合使用时应根据对血压影响程度大小酌情选用。</span></p></section></section></section></section></section></section></section></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="33040"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-width: 1px;border-style: dashed;border-color: rgb(255, 0, 0);box-sizing: border-box;"><section style="width:50%;height:16px;margin-left:auto;background-color:#fff6f5;" data-width="50%"><br/></section><section style="display: flex;justify-content:center;align-items:flex-start;"><section style="width:97%;display: flex;justify-content:center;align-items:flex-end;" data-width="97%"><section style="width:16px;height:100px;background-color:#fff6f5;"><br/></section><section style="width: 97%;margin-right: auto;margin-left: auto;" data-width="97%"></section></section><section style="width:16px;height:100px;background-color:#fff6f5;"><br/></section></section><section style="width:50%;height:16px;background-color:#fff6f5;" data-width="50%"><br/></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);"> 但是，因服用非甾体类抗炎药物引起的血压升高的人群通常情况下停药后血压会慢慢恢复。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"> 老年人合并风湿性疾病、关节退行性变、骨质疏松等较常见，服用止痛药的机率相对较大，而非甾体抗炎药是非处方用药，很多患者在药房自行购买服用。但是长期服用非处方止痛药的人，<span style="color: rgb(255, 76, 65);">一定要注意以下七点</span>。</span></p><p><section data-support="96编辑器" data-style-id="33040"><section><section><section><section><section><section data-support="96编辑器" data-style-id="33040"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-width: 1px;border-style: dashed;border-color: rgb(255, 0, 0);box-sizing: border-box;"><section style="width:50%;height:16px;margin-left:auto;background-color:#fff6f5;" data-width="50%"><br/></section><section style="display: flex;justify-content:center;align-items:flex-start;"><section style="width:97%;display: flex;justify-content:center;align-items:flex-end;" data-width="97%"><section style="width:16px;height:100px;background-color:#fff6f5;"><br/></section><section style="width: 97%;margin-right: auto;margin-left: auto;" data-width="97%"></section></section><section style="width:16px;height:100px;background-color:#fff6f5;"><br/></section></section><section style="width:50%;height:16px;background-color:#fff6f5;" data-width="50%"><br/></section></section></section></section></section></section></section></section></section></section><section style="white-space: normal;"><section><section><section><section><section><section><section data-support="96编辑器" data-style-id="12554"><section><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 247, 247);border-radius: 5px;box-sizing: border-box;"><section style="padding: 10px;background-color: rgb(255, 247, 247);border-radius: 5px;box-sizing: border-box;"><section style="padding: 10px 8px 6px;box-sizing: border-box;"><section style="color: rgb(0, 0, 0);letter-spacing: 0px;line-height: 20px;"><p style="line-height: 2em;letter-spacing: 1px;"><span style="font-size: 16px;">一、每3~6个月去看一次医生，每个月至少测1次血压；</span><br/></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">二、连续服用3~5天，如果</span><span style="font-size: 16px;">疼痛</span><span style="font-size: 16px;">缓解不明显，一定要及时就诊；</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">三、患有胃肠道疾病、</span><span style="font-size: 16px;">哮喘</span><span style="font-size: 16px;">、高血压等慢</span><span style="font-size: 16px;">性病</span><span style="font-size: 16px;">的人，用药前最好先向医生或药师咨询，选择最合适的一种非处方止痛药；</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">四、高血压病史或有高血压家族史患者尽量选用不良反应小的药物与剂型，若服用期间出现血压升高时建议选用钙离子拮抗剂进行降压治疗<span style="color: rgb(0, 0, 0);font-size: 16px;letter-spacing: 1px;background-color: rgb(255, 247, 247);">；</span></span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">五、尽量避免多种非甾体抗炎药物的重复使用，减少不良反应的发生；</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">六、严格掌握非甾体抗炎药物的适应症与禁忌症，谨防药物滥用情况的发生；</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">七、一经发现患者出现相关不良反应症状买药立即停止使用该药物，并采取治疗措施，降低危害性。</span></p></section></section></section></section></section></section></section></section></section></section></section></section></section></p><p style="white-space: normal;letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><p><section data-style-id="30285" style="white-space: normal;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;"><section style="padding-top: 20px;padding-bottom: 20px;box-sizing: border-box;"><section style="display: flex;justify-content: space-between;align-items: flex-start;"><section><section style="width: 60px;height: 1px;background-color: rgb(255, 0, 0);"><br/></section></section></section></section></section></p><p style="white-space: normal;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, 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0%;height: auto;align-self: flex-start;"><section style="text-align: right;justify-content: flex-end;"><section style="display: inline-block;width: 8px;height: 45px;vertical-align: top;overflow: hidden;"><section style="text-align: center;"><section style="vertical-align: middle;display: inline-block;line-height: 0;width: 7.8267px;height: auto;"><svg xmlns="http://www.w3.org/2000/svg" x="0px" y="0px" viewbox="0 0 1.5 8.7" style="vertical-align: middle;width: 100%;" width="100%" data-width="100%"><g><path d="M1.5,0.2C0.8,0.2,0.2,0.6,0.2,1v6.2C0.5,6.9,1,6.8,1.5,6.8V0.2z" fill="rgb(255,255,255)"></path></g><g><path d="M0.2,7.7H0V1c0-0.5,0.7-1,1.5-1v0.2C0.8,0.2,0.2,0.6,0.2,1v6.2C0.5,6.9,1,6.8,1.5,6.8V7C0.8,7,0.2,7.3,0.2,7.7 z" fill="rgb(7,48,196)"></path></g><g><path d="M1.5,8.7C0.7,8.7,0,8.3,0,7.7s0.7-0.9,1.5-0.9V7C0.8,7,0.2,7.3,0.2,7.7s0.6,0.7,1.3,0.7V8.7z" fill="rgb(7,48,196)"></path></g><g><path d="M1.5,7C0.8,7,0.2,7.3,0.2,7.7s0.6,0.7,1.3,0.7V7z" fill="#5f9cef"></path></g></svg></section></section></section></section></section><section style="margin-left: -1px;display: inline-block;vertical-align: top;width: auto;flex: 100 100 0%;align-self: flex-start;height: auto;"><section style="justify-content: flex-start;"><section style="padding-right: 20px;padding-left: 10px;display: inline-block;vertical-align: top;overflow: hidden;height: 36px;width: auto;min-width: 10%;border-width: 1px;border-bottom-right-radius: 100px;border-style: solid solid solid none;border-color: rgb(7, 48, 196) rgb(7, 48, 196) rgb(7, 48, 196) rgb(138, 50, 222);border-top-right-radius: 100px;border-bottom-left-radius: 0px;box-sizing: border-box;"><section style="color: rgb(7, 48, 196);text-align: center;letter-spacing: 2px;line-height: 2.2;"><p><strong>联系方式</strong></p></section></section></section></section></section></section><section style="margin-bottom: 10px;"><section style="padding-right: 20px;padding-left: 20px;color: rgb(62, 62, 62);letter-spacing: 1.8px;line-height: 1.8;box-sizing: border-box;"><section style="line-height: 2em;">1、咨询株洲恺德心血管病医院订阅号<strong><span style="color: rgb(7, 48, 196);">在线客服；</span></strong><br data-filtered="filtered"/>2、咨询电话：<strong><span style="color: rgb(7, 48, 196);">0731-28260137</span></strong></section><section style="line-height: 2em;">3、联系地址：株洲恺德心血管病医院<span style="color: rgb(7, 48, 196);"><strong>第二住院大楼3楼（心血管内三科）</strong></span></section></section></section></section></section></section></section></section><section><section style="letter-spacing: 0.544px;text-align: right;font-size: 12px;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 16px;letter-spacing: 0.544px;"><section style="border-top: 1px solid rgb(7, 48, 196);line-height: 0;box-sizing: border-box;"><section data-filtered="filtered" style="line-height: 0;width: 0px;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section><section style="margin-top: 3px;border-top: 4px solid rgb(7, 48, 196);line-height: 0;box-sizing: border-box;"><section data-filtered="filtered" style="line-height: 0;width: 0px;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section></section><section style="letter-spacing: 0.544px;"><p><span style="letter-spacing: 0.544px;">文案：刘平平</span><span style="letter-spacing: 0.544px;font-size: 17px;text-align: justify;"></span></p></section></section></section></section></p><h2 style="font-weight: bold;white-space: normal;line-height: 1.6em;"><br/></h2><p><br/></p><link rel="stylesheet" href="//bbs.zhuzhou.com/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_LI8" id="wcn_editor_css"/>
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