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降压药对孩子和孕妇有影响么

降压药对孩子和孕妇的影响是一个复杂的问题,需要综合考虑多方面的因素。以下是相关的知识点和研究结果:

  1. 对孕妇的影响

    • 高血压是孕期常见的疾病,可能导致母婴健康问题。孕期高血压的治疗目标通常是将血压控制在120~160/80~110 mmHg之间。
    • 使用降压药物可以有效降低孕妇的血压,从而减少严重高血压的风险。然而,降压药物的使用需要谨慎,因为它们可能对胎儿产生潜在影响。
  2. 对胎儿的影响

    • 研究表明,使用抗高血压药物对胎儿或新生儿死亡(包括流产)的风险影响很小(aRR=0.72; 95% CI=[0.50, 1.04])。
    • 对小于胎龄儿的风险影响也很小(aRR=0.96; 95% CI=[0.78, 1.18])。
    • 对早产(少于37周)的风险影响很小(aRR=0.96; 95% CI=[0.83, 1.12])。
  3. 对儿童的影响

    • 儿童高血压的定义是收缩压和/或舒张压≥95百分位,且在至少3次测量中持续存在。对于非药物措施无效的持续性高血压,抗高血压药物是安全、有效且耐受性良好的选择。
  4. 药物选择

    • 常用的降压药物包括ACE抑制剂、血管紧张素受体阻滞剂、钙通道阻滞剂、β-受体阻滞剂和利尿剂。这些药物在儿童中被认为是安全的。
  5. 临床建议

    • ACOG(美国妇产科医师学会)建议在以下情况下进行降压治疗:患有先兆子痫、收缩压持续≥160 mmHg或舒张压持续≥110 mmHg的慢性高血压孕妇。

综上所述,降压药在孕妇和儿童中的使用需要在医生的指导下进行,以确保在控制高血压的同时,将对胎儿和儿童的潜在风险降到最低。定期的产前检查和对高血压的早期检测与预防是减少不良影响的重要措施。

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