男，61岁，患有高血压，同时伴有2型糖尿病，尿蛋白（+）。选择最佳降压药物为（） -题库考试答案搜索网

男，61岁，患有高血压，同时伴有2型糖尿病，尿蛋白（+）。选择最佳降压药物为（）

单选题

2021-12-26 20:40

A、利尿剂
B、钙拮抗剂
C、ACEI
D、α受体阻滞剂
E、β受体阻滞剂

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正确答案

试题解析

ACEI类具有改善胰岛素抵抗和减少尿蛋白作用，在肥胖、糖尿病和心脏、肾脏靶器官受损的高血压患者具有相对较好的疗效，特别适用于伴有心力衰竭、心肌梗死后、糖耐量减退或糖尿病肾病的高血压患者。高血钾症、妊娠妇女和双侧肾动脉狭窄患者慎用。钙拮抗剂可用于合并糖尿病、冠心病或外周血管病患者，长期治疗时还有抗动脉粥样硬化作用。虽然糖尿病不是使用β受体阻滞剂的禁忌症，但它增加胰岛素抵抗，还可能掩盖和延长降糖治疗过程中的低血糖症，使用时应加以注意。利尿剂适用于轻、中度高血压，在盐敏感性高血压、合并肥胖或糖尿病、更年期女性和老年人高血压有较强降压效应。α受体拮抗药对轻、中度高血压有明确疗效

标签：内科北京住院医师康复医学Ⅰ阶段高血压皮肤科住院医师心脏内科上海住院医师神经内科北京住院医师内科Ⅰ阶段

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