高血压病人时间用药护理的临床观察毕业论文.doc

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1、高血压病人时间用药护理的临床观察毕业论文目录中文摘要········································································································1英文摘要········································································································3研究论文高血压病人时间用药护理的临床观察前言············

2、····························································································5资料与方法····························································································6结果·················································································

3、······················8附图·······································································································10附表·······································································································11讨论···································

4、····································································14结论·······································································································23参考文献·····························································································

5、·24综述高血压病人时间用药护理及评估进展·······································27致谢···············································································································36个人简历·····························································································

6、··········37研究论文前言高血压病是临床常见的疾病，常引严重的心、脑、肾脏等靶器官的并发症，是脑卒中和冠心病的主要危险因素，我国高血压病患者人数呈上升趋势，成为国民致残，致死的主要病因之一。但我国高血压病患者对该病知晓率低、治疗率低、控制率低。因此做好高血压的诊治具有深远的社会意义。降压治疗可使高血压患者明显获益，最近一项荟萃分析表明血压下降4.6/2.2mmHg以上就可以使心血管事件发生率明显下降[1]。然而在获得同等水平的血压下降，不同的治疗方案可产生不同的临床获益，如在ASCOT试验中，以氨氯地平为基础的降压方案和以阿替洛尔为

7、基础的降压方案使患者血压下降差值为2.7/1.9mmHg，然而在以氨氯地平为基础的降压方案组中冠脉事件及卒中事件获益率明显高于以阿替洛尔为基础的降压方案组，对该试验进一步分析发现在以氨氯地平为基础的降压方案组中血压变异明显小于以阿替洛尔为基础的降压方案组，说明血压变异性可部分的解释两组临床获益差别[2]。高血压时除血压增高对靶器官产生损害外，血压节律异常也会对机体造成损害，夜间血压增高及非杓型血压可导致左心室充盈异常及舒张功能受损[3]。非杓型血压导致人体内分泌紊乱，最终引起心力衰竭[4-6]。此外在通常情况下，人从睡眠到觉醒及开始活动，体内

8、的交感神经系统活性、肾素、血管紧张素II、醛固酮等物质活性逐渐增高，其导致清晨觉醒后数小时内血压会有所升高，如果交感神经过度激活等病理原因晨峰血压升高幅度过大，则心