哌唑嗪治疗铅中毒所致高血压危象：一例报告
Lead poisoning-induced hypertensive crisis managed by prazosin: a case report.
作者信息
Dadpour Bita, Mehrpour Omid, Etemad Leila, Moshiri Mohammad
机构信息
Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran ; Addiction Research Centre, Mashhad University of Medial Toxicology, Mashhad, IR Iran.
Addiction Research Centre, Mashhad University of Medial Toxicology, Mashhad, IR Iran ; Birjand Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Science, Birjand, IR Iran.
出版信息
Iran Red Crescent Med J. 2013 Jun;15(6):526-8. doi: 10.5812/ircmj.4557. Epub 2013 Jun 5.
INTRODUCTION
Chronic lead exposure is known to be a risk factor for hypertension (HTN). No specific medication is recommended for the treatment of lead-induced hypertension (LIHTN).
CASE PRESENTATION
Our patient was a male admitted with the chief complaint of chronic abdominal pain. His whole blood lead level was reported to be 1961 µg/L. He also mentioned a previous history of HTN managed by propranolol (10 mg, TDS). He discharged himself by giving written consent and 19 days later, he was re-admitted due to high blood pressure of 220/140 mmHg. His Blood pressure (BP) was decreased to 180/110 mmHg with sublingual captopril; but, in maintenance therapy, higher doses of captopril could not further decrease BP. Amlodipine was tried which was discontinued due to the patient intolerance. Prazosin was then administered in gradual increasing doses up to 1 mg twice a day and captopril was tapered.
CONCLUSIONS
We would like to suggest that LIHTN may better be managed by alpha blockers compared with converting enzyme inhibitors.
引言
已知慢性铅暴露是高血压（HTN）的一个风险因素。对于铅诱导的高血压（LIHTN），目前尚无推荐的特定治疗药物。
病例介绍
我们的患者是一名男性，以慢性腹痛为主诉入院。据报告他的全血铅水平为1961μg/L。他还提及曾有高血压病史，之前使用普萘洛尔（10mg，每日三次）治疗。他签署书面同意书后自行出院，19天后，因血压高达220/140mmHg再次入院。舌下含服卡托普利后他的血压（BP）降至180/110mmHg；但是，在维持治疗中，更高剂量的卡托普利未能进一步降低血压。尝试使用氨氯地平，但因患者不耐受而停药。随后逐渐增加哌唑嗪剂量至每日两次1mg，并逐渐减少卡托普利剂量。
结论
我们建议，与转换酶抑制剂相比，α受体阻滞剂可能更适合用于管理LIHTN。
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