中国急诊高血压诊疗专家共识（2017修订版）

doi:10.3969/j.issn.1002-1949.2018.01.001

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摘要急诊高血压是指在急诊科（emergency department）就诊的由于血压急性升高伴或不伴靶器官功能损害的一组临床综合征，急诊高血压涵盖高血压急症（hypertensive emergencies）和高血压亚急症（hypertensive urgencies）两个概念。由于患者基础条件不同，急剧升高的血压对靶器官影响不尽相同，一部分患者因血压的急性升高导致靶器官功能受损，继而造成严重后果，急诊高血压的处理直接影响患者的预后。本文重点论述高血压急症。 中国成人高血压患病率为25.2%，测算人数为2.7亿［1］。其中，1%~2%的高血压患者发生高血压急症［2］。高血压急症发病急，预后差，高血压急症、亚急症患者急性期病死率达6.9%，发病后90天病死率和再住院率高达11%和37%，其中1/4是由于反复发作急性严重的高血压［3］。部分严重的高血压急症患者12个月内病死率达50%［4］。高血压急症临床表现多样，为统一高血压急症的定义、诊断和治疗标准，规范临床诊治，改善患者预后及生活质量，中国医师协会急诊医师分会联合中国高血压联盟众多专家，就这一临床重要问题在2010年做出统一共识。近几年高血压急症领域在国内外开展了大量研究，为急诊高血压诊断和治疗提供了更多的循证医学证据，故中国医师协会急诊医师分会、中国高血压联盟决定启动《中国急诊高血压诊疗专家共识》的修订工作。 共识委员会写作组专家在参考国内和欧美相关指南及共识，并在近年来发表的相关临床试验结果基础上，结合国内临床实际情况，经过专家们的共同努力修订这一共识，并提交共识委员会讨论通过，以期制定一个适合我国国情的高血压急症诊治指导性文件。共识旨在帮助从事急诊医疗工作的医师对这类急症患者做出适当的评估与治疗，对高血压急症建立合理的综合处理模式以及制定不同受损器官的降压策略。共识只作为急诊高血压诊疗过程中的指导，实践中请参照临床实际情况。

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	中国医师协会急诊医师分会
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	北京高血压防治协会

关键词 ：急诊, 高血压, 诊疗, 共识

收稿日期: 2017-12-10

通讯作者: 周荣斌，中国人民解放军陆军总医院，E-mail:dr_zhourongbin@sina.com；于学忠，北京协和医院，E-mail：yxz@medmail.com.cn；杨艳敏，中国医学科学院阜外心血管病医院，E-mail：yymwin@gmail.com；王文，中国医学科学院阜外心血管病医院，E-mail：wangwen5588@126.com。

引用本文:

中国医师协会急诊医师分会，中国高血压联盟，北京高血压防治协会. 中国急诊高血压诊疗专家共识（2017修订版）[J]. 中国急救医学, 2018, 38(1): 1-13.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.01.001 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I1/1

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