08.2第二节课原发性高血压.pdfVIP

Essential Hypertension (EH) • Classify and definition • Epidemiology • Pathogenesis and mechanism • Pathophysiology and Pathology • Clinical manifestation and complication • Laboratory investigations 5. Laboratory investigations • Diagnosis and differential diagnosis • Treatment • Special types hypertension 1 Laboratory investigations • Routine investigations Blood biochemistry (K+, Glu, TC, TG, HDL, LDL, Bun, Cr) Blood/Urine routine examination ECG • Recommend investigations ABPM, UCG, ACR, fundus examination, chest radiography, ABI, pulse wave velocity, Homocysteine Ultrasonography Carotid color Ultr, kidney artery • Optional investigations Blood Renin, Blood epinephrine/ norepinephrine, Blood cortisol activity, CT/MRI 2 Laboratory investigations -1 ① Plasma renin(肾素) activity aldosterone (醛固酮) ，to identify secondary hypertension ② Echocardiography, to detect ventricular hypertrophy ③ Vascular ultrasonography should be performed if arterial disease is suspected ④ Renal ultrasonography should be performed if renal disease is suspected ⑤ Serum potassium, since hypokalemia is typical of hyperaldosteronism （醛固酮增多症） ⑥ Fasting glucose, since hyperglycemia is noted in diabetes and pheochromocytoma （嗜铬细胞瘤） ⑦ Plasma cholesterol, as an indicator of atherosclerosis risk 3 Laboratory investigations -2 ⑧ Serum uric acid(尿酸), since if elevated it is a contraindication to diuretic therapy ⑨ Electrocardiography, to detect ventricular hypertrophy ⑩ Chest X-ray, to detect le