{"id":34389,"date":"2019-09-25T00:45:04","date_gmt":"2019-09-24T16:45:04","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=34389"},"modified":"2019-09-23T10:43:18","modified_gmt":"2019-09-23T02:43:18","slug":"%e5%9a%b4%e6%a0%bc%e8%a1%80%e5%a3%93%e6%8e%a7%e5%88%b6%e6%9c%89%e5%8a%a9%e6%96%bc%e7%b6%ad%e6%8c%81%e5%a4%a7%e8%85%a6%e5%81%a5%e5%ba%b7","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=34389","title":{"rendered":"\u56b4\u683c\u8840\u58d3\u63a7\u5236\u6709\u52a9\u65bc\u7dad\u6301\u5927\u8166\u5065\u5eb7"},"content":{"rendered":"

\u9ad8\u8840\u58d3\u5df2\u77e5\u662f\u8a31\u591a\u4f75\u767c\u75c7\u7684\u5371\u96aa\u56e0\u7d20\uff0c\u5305\u62ec\u5fc3\u81df\u75c5\u3001\u4e2d\u98a8\u3001\u5fc3\u8840\u7ba1\u75be\u75c5\u3001\u773c\u75be\u7b49\u3002\u8840\u58d3\u63a7\u5236\u662f\u9810\u9632\u9019\u4e9b\u4f75\u767c\u75c7\u76f8\u7576\u91cd\u8981\u7684\u74b0\u7bc0\uff0c\u4e0d\u904e\u8840\u58d3\u63a7\u5236\u662f\u5426\u4e5f\u80fd\u964d\u4f4e\u8f15\u5ea6\u8a8d\u77e5\u529f\u80fd\u969c\u7919\u548c\u5931\u667a\u75c7\u7684\u98a8\u96aa\uff1f\u5f9e\u7f8e\u570b\u570b\u5bb6\u885b\u751f\u7814\u7a76\u9662\u6700\u8fd1\u767c\u8868\u7684 SPRINT MIND \u81e8\u5e8a\u8a66\u9a57\u7d50\u679c\uff0c\u5176\u652f\u6301\u4e86\u300c\u56b4\u683c\u8840\u58d3\u63a7\u5236\u300d\u6709\u52a9\u65bc\u7dad\u6301\u300c\u5927\u8166\u5065\u5eb7\u300d\u3002<\/strong><\/span><\/p>\n

\"\"
\u5716\u7247\u51fa\u8655 @pixabay<\/figcaption><\/figure>\n

\u64b0\u6587\uff5c<\/strong>\u694a\u671d\u5091<\/strong><\/p>\n

\u25cfSP<\/strong>RINT <\/strong>\u8a66\u9a57\u5148\u8b49\u5be6\u56b4\u683c\u8840\u58d3\u63a7\u5236\u66f4\u80fd\u964d\u4f4e\u5fc3\u8840\u7ba1\u75be\u75c5\u98a8\u96aa\u3001\u6b7b\u4ea1\u98a8\u96aa<\/strong><\/span><\/p>\n

\u6210\u4eba\u7684\u6b63\u5e38\u8840\u58d3\u61c9\u8a72\u5728 120\/80 mmHg (\u6536\u7e2e\u58d3\/\u8212\u5f35\u58d3) \u4ee5\u4e0b\uff0c\u5982\u679c\u7576\u6536\u7e2e\u58d3 > 140 mmHg \u6216\u8212\u5f35\u58d3 > 90 mmHg\uff0c\u5176\u4e2d\u4efb\u4f55\u4e00\u9805\u8d85\u904e\u4e0a\u8ff0\u6578\u503c\uff0c\u5247\u4ee3\u8868\u6709\u9ad8\u8840\u58d3\u3002\u7f8e\u570b\u5fc3\u81df\u5354\u6703\u5728 2017 \u5e74\u53c8\u9032\u4e00\u6b65\u5c07\u6a19\u6e96\u4e0b\u4fee\u81f3\u66f4\u56b4\u683c\u7684 130\/80 mmHg\uff0c\u4e0d\u904e\u76ee\u524d\u53f0\u7063\u3001\u6b50\u6d32\u53ca\u4e16\u754c\u885b\u751f\u7d44\u7e54\u90fd\u66ab\u6642\u6c92\u6709\u8ddf\u9032\uff0c\u4ecd\u662f\u4ee5 140\/90 mmHg \u70ba\u4e3b\u3002<\/p>\n

\u70ba\u4ec0\u9ebc\u7f8e\u570b\u5fc3\u81df\u5354\u6703\u6562\u5982\u6b64\u7279\u7acb\u7368\u884c\uff1f\u8a02\u4e0b\u66f4\u56b4\u82db\u7684\u8840\u58d3\u6a19\u6e96\uff1f\u5176\u6191\u85c9\u7684\u8b49\u64da\u5c31\u662f\u7531\u7f8e\u570b\u570b\u5bb6\u885b\u751f\u7814\u7a76\u9662 (NIH) \u5728 2010 \u5e74\u555f\u52d5\u7684 SPRINT (Systolic Blood Pressure Intervention\uff0c\u6536\u7e2e\u58d3\u4ecb\u5165) \u8a66\u9a57\uff0c\u7814\u7a76\u6700\u521d\u76ee\u7684\u662f\u5728\u6bd4\u8f03\u6a19\u6e96\u8840\u58d3\u63a7\u5236 (< 140 mmHg) \u8207\u56b4\u683c\u8840\u58d3\u63a7\u5236 (< 120 mmHg) \u5c0d\u5fc3\u8840\u7ba1\u5065\u5eb7\u548c\u6b7b\u4ea1\u7387\u7684\u5f71\u97ff\uff0c\u8a66\u9a57\u5171\u6709\u8d85\u904e 9,300 \u540d\u5e74\u9f61\u5927\u65bc 50 \u6b72\u4e26\u4e14\u5fc3\u8840\u7ba1\u75be\u75c5\u98a8\u96aa\u9ad8\u7684\u53c3\u8207\u8005\uff0c\u5728\u4e4b\u524d 2015 \u5e74\u767c\u8868\u7684\u7d50\u679c\u5c31\u5df2\u8b49\u5be6\uff0c\u7d93\u904e 3. 3 \u5e74\u7684\u56b4\u683c\u8840\u58d3\u63a7\u5236 (< 120 mmHg) \u66f4\u80fd\u300c\u986f\u8457\u964d\u4f4e\u5fc3\u8840\u7ba1\u75be\u75c5\u98a8\u96aa\u3001\u6b7b\u4ea1\u98a8\u96aa\u300d\u3002<\/p>\n

\u25cfSPRINT MIND<\/strong>\u8a66\u9a57\u60f3\u8fa8\u660e\u56b4\u683c\u8840\u58d3\u63a7\u5236\u5c0d\u5931\u667a\u75c7\u7684\u5f71\u97ff<\/strong><\/span><\/p>\n

\u8d81\u8457 SPRINT \u8a66\u9a57\u5148\u524d\u7684\u597d\u52e2\u982d\uff0c\u91ab\u5b78\u754c\u4e5f\u9084\u4e0d\u6e05\u695a\u9ad8\u8840\u58d3\u5c0d\u65bc\u8f15\u5ea6\u8a8d\u77e5\u529f\u80fd\u969c\u7919\u548c\u5931\u667a\u75c7\u98a8\u96aa\u7684\u5f71\u97ff (\u4e5f\u5c31\u662f\u60f3\u4e86\u89e3\u662f\u5426\u80fd\u9810\u9632\u963f\u8332\u6d77\u9ed8\u75c7)\uff0c\u56e0\u6b64\u53c8\u518d\u63a8\u51fa\u81e8\u5e8a\u8a66\u9a57 SPRINT MIND (Memory and Cognition in Decreased Hypertension) \u8981\u4f86\u63a2\u7a76\u6b64\u4e00\u5927\u7591\u554f\u3002SPRINT MIND \u7814\u7a76\u5728 2019 \u5e74 1 \u6708\u767c\u8868\u65bc JAMA<\/em>\uff0c\u7136\u800c\u7d50\u679c\u4e0d\u5b8c\u5168\u76e1\u5982\u4eba\u610f\uff0c\u56b4\u683c\u8840\u58d3\u63a7\u5236 (< 120 mmHg) \u6bd4\u8d77\u6a19\u6e96\u8840\u58d3\u63a7\u5236 (< 140 mmHg)\uff0c\u5728\u5931\u667a\u75c7\u767c\u751f\u7387\u65b9\u9762\u6c92\u6709\u592a\u5927\u5dee\u7570 (7.2% vs. 8.6%)\uff1b\u800c\u5728\u8f15\u5ea6\u8a8d\u77e5\u969c\u7919\u7684\u767c\u751f\u7387\u5247\u6709\u660e\u986f\u5730\u6e1b\u5c11 (14.6% vs. 18.3%)\u3002\u7531\u65bc\u9019\u6a23\u7684\u7d50\u679c\u9084\u4e0d\u5920\u78ba\u5207\uff0c\u6578\u64da\u50c5\u662f\u504f\u4e2d\u6027\u53c8\u597d\u4e86\u4e00\u9ede\uff0c\u6b64\u6642\u9084\u7121\u6cd5\u7d55\u5c0d\u7406\u76f4\u6c23\u58ef\u5730\u8aaa\u56b4\u683c\u8840\u58d3\u63a7\u5236\u6709\u9810\u9632\u5931\u667a\u75c7\u7684\u597d\u8655\u3002SPRINT MIND \u7684\u7814\u7a76\u8005\u8a8d\u70ba\u8a66\u9a57\u4e2d\u7684\u5931\u667a\u75c7\u75c5\u4f8b\u5c11\u65bc\u9810\u671f\uff0c\u56e0\u6b64\u53ef\u80fd\u5230\u8a72\u7814\u7a76\u7684\u7d42\u9ede\u6642\uff0c\u56b4\u683c\u8840\u58d3\u63a7\u5236\u8207\u5931\u667a\u75c7\u7684\u8b70\u984c\u9084\u7121\u6cd5\u7372\u5f97\u5145\u5206\u7684\u8003\u91cf\u3002<\/p>\n

\u5176\u5be6\uff0c\u7814\u7a76\u8d70\u5230\u9019\u88e1\u6709\u9ede\u6210\u4e86\u9a0e\u864e\u96e3\u4e0b\u4e4b\u52e2\uff0c\u5c31\u50cf\u662f\u982d\u5df2\u7d93\u6d17\u4e00\u534a\u4e86\uff0c\u53ea\u597d\u7e7c\u7e8c\u6d17\u4e0b\u53bb\u3002\u7814\u7a76\u8005\u52e2\u5fc5\u5f97\u518d\u4ed4\u7d30\u91d0\u6e05\u56b4\u683c\u8840\u58d3\u63a7\u5236\u662f\u5426\u771f\u7684\u80fd\u5920\u9810\u9632\u5931\u667a\u75c7\uff1f\u6240\u4ee5 SPRINT MIND \u8a66\u9a57\u7576\u7136\u5f97\u6301\u7e8c\u9032\u884c\uff0c\u4e26\u7528\u66f4\u7cbe\u78ba\u7684\u65b9\u6cd5\u4f86\u9a57\u8b49\u5148\u524d\u7684\u7d50\u679c\u5230\u5e95\u662f\u504f\u5411\u54ea\u4e00\u908a\u3002\u7814\u7a76\u5148\u524d\u4f7f\u7528\u7684\u65b9\u6cd5\u662f\u8a8d\u77e5\u80fd\u529b\u6e2c\u8a66\u7684\u8499\u7279\u5229\u723e\u8a8d\u77e5\u8a55\u4f30\u91cf\u8868 (montreal cognitive assessment, MoCA)\uff0c\u800c\u65b0\u7684\u65b9\u6cd5\u5247\u662f\u9078\u64c7\u4e86\u8a3a\u65b7\u5931\u667a\u75c7\u7684\u300c\u9ec3\u91d1\u6a19\u6e96\u300d\uff0c\u4e5f\u5c31\u662f\u8166\u90e8\u7684\u6838\u78c1\u5171\u632f\u651d\u5f71 (magnetic resonance imaging, MRI)\uff0c\u679c\u7136\u300c\u6709\u5716\u6709\u771f\u76f8\u300d\u7684\u9053\u7406\u8d70\u5230\u54ea\u88e1\u90fd\u9069\u7528\u554a\u3002<\/p>\n

\u25cfSPRINT MIND<\/strong>\u8a66\u9a57\u8b49\u5be6\u56b4\u683c\u8840\u58d3\u63a7\u5236\u53ef\u4ee5\u6e1b\u7de9\u8001\u5316\u76f8\u95dc\u7684\u8166\u640d\u50b7<\/strong><\/span><\/p>\n

\u63a5\u8457\u4f86\u63ed\u66c9\u7b54\u6848\uff0cSPRINT MIND \u7814\u7a76\u8005\u6bd4\u8f03\u4e86 449 \u540d\u53c3\u8207\u8005\uff0c\u5728\u7814\u7a76\u958b\u59cb\u4e4b\u524d\u8207\u7d93\u904e 4 \u5e74\u5f8c\u7684\u8166\u90e8\u6383\u63cf MRI \u5f71\u50cf\uff0c\u7d50\u679c\u986f\u793a\u56b4\u683c\u8840\u58d3\u63a7\u5236\u7d44 (< 120 mmHg) \u7684\u8166\u90e8\u767d\u8cea\u75c5\u8b8a\u7e3d\u9ad4\u7a4d\u5e73\u5747\u589e\u52a0\u91cf\u70ba 0.92 cm3<\/sup>\uff0c\u300c\u986f\u8457\u5c0f\u65bc\u300d\u6a19\u6e96\u8840\u58d3\u63a7\u5236\u7d44 (< 140 mmHg) \u7684\u75c5\u8b8a\u589e\u52a0\u91cf 1.45 cm3<\/sup>\u3002\u9019\u4ee3\u8868\u8457\u56b4\u683c\u8840\u58d3\u63a7\u5236\u53ef\u80fd\u662f\u300c\u6e1b\u7de9\u300d\u8166\u90e8\u767d\u8cea\u75c5\u8b8a\u7a4d\u7d2f\u7684\u95dc\u9375\u4e4b\u4e00\uff0c\u800c\u9019\u4e9b\u75c5\u8b8a\u4e5f\u8ddf\u8001\u4eba\u5931\u667a\u75c7\u8207\u8f15\u5ea6\u8a8d\u77e5\u969c\u7919\u7684\u767c\u5c55\u5b58\u5728\u95dc\u806f\uff0c\u6b64\u8b49\u64da\u4e5f\u540c\u6642\u652f\u6301\u4e86\u5148\u524d\u7684\u7814\u7a76\u7d50\u679c\u300c\u56b4\u683c\u8840\u58d3\u63a7\u5236\u53ef\u4ee5\u6e1b\u5c11\u8f15\u5ea6\u8a8d\u77e5\u969c\u7919\u7684\u767c\u751f\u7387\u300d\u3002<\/p>\n

\u8840\u58d3\u904e\u9ad8\u7684\u58de\u8655\u4e0d\u8a00\u800c\u55bb\uff0c\u4f46\u597d\u6d88\u606f\u662f\u9ad8\u8840\u58d3\u70ba\u4e00\u7a2e\u80fd\u5920\u6cbb\u7642\u7684\u75be\u75c5\uff0c\u5982\u679c\u7a4d\u6975\u6cbb\u7642\u9ad8\u8840\u58d3\uff0c\u53ef\u80fd\u5c0d\u8a8d\u77e5\u53ca\u5927\u8166\u7d50\u69cb\u5e36\u4f86\u76ca\u8655\u3002\u95dc\u65bc\u6536\u7e2e\u58d3\u7684\u6cbb\u7642\u76ee\u6a19\u8981\u8a02\u5728\u539f\u672c\u7684 < 140 mmHg\uff0c\u6216\u662f\u7f8e\u570b\u5fc3\u81df\u5354\u6703\u4e0b\u4fee\u7684 < 130 mmHg\uff1f\u7531\u65bc\u4e26\u975e\u6240\u6709\u9ad8\u8840\u58d3\u60a3\u8005\u90fd\u9069\u5408\u904e\u65bc\u6fc0\u9032\u7684\u964d\u8840\u58d3\u6cbb\u7642\u65b9\u5f0f\uff0c\u4e0d\u540c\u65cf\u7fa4\u61c9\u6709\u4e0d\u540c\u7684\u8840\u58d3\u76ee\u6a19\u503c\u3002\u81f3\u65bc\u8840\u58d3\u6a19\u6e96\u76ee\u6a19\u503c\u8981\u8a02\u5728\u54ea\uff1f\u5c31\u7559\u7d66\u91ab\u5b78\u754c\u6301\u7e8c\u63a2\u8a0e\uff0c\u771f\u7406\u7e3d\u6709\u8d8a\u8faf\u8d8a\u660e\u7684\u90a3\u4e00\u5929\u3002\u6587\u672b\u5efa\u8b70\uff0c\u9ad8\u8840\u58d3\u60a3\u8005\u61c9\u8a72\u5411\u91ab\u5e2b\u8aee\u8a62\uff0c\u78ba\u5b9a\u5c0d\u81ea\u5df1\u6700\u597d\u7684\u8840\u58d3\u76ee\u6a19\u503c\uff0c\u4ee5\u53ca\u8a72\u5982\u4f55\u9054\u6210\u76ee\u6a19\uff0c\u4f8b\u5982\u8abf\u6574\u98f2\u98df\u548c\u751f\u6d3b\u7fd2\u6163\uff0c\u6216\u662f\u670d\u7528\u9069\u7576\u7684\u964d\u8840\u58d3\u85e5\u7269\u3002\u7e3d\u4e4b\uff0c\u9060\u96e2\u9ad8\u8840\u58d3\uff0c\u662f\u6d3b\u5f97\u66f4\u5065\u5eb7\u9577\u4e45\u7684\u4e0a\u4e0a\u4e4b\u7b56\u3002<\/p>\n

 <\/p>\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong><\/p>\n

    \n
  1. NIH News Releases. 2019 Aug. 13. Intensive blood pressure control may slow age-related brain damage.<\/a><\/li>\n
  2. The SPRINT MIND Investigators. JAMA. 2019 Feb 12;321(6):553-561. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial.<\/a><\/li>\n
  3. The SPRINT MIND Investigators. JAMA 2019 Aug 13;322(6):524-534. Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions.<\/a><\/li>\n
  4. \u5168\u6c11\u5065\u5eb7\u57fa\u91d1\u6703\uff0c\u597d\u5065\u5eb7\u7b2c 44 \u671f\uff0c\u9ad8\u8840\u58d3\u6a19\u6e96\u8da8\u56b4\uff0c\u5982\u4f55\u907f\u514d\u8840\u58d3\u300c\u9ad8\u4eba\u4e00\u7b49\u300d\uff1f<\/a><\/li>\n<\/ol>\n

     <\/p>\n

    --
    \n\u4f5c\u8005<\/span>\uff1a\u694a\u671d\u5091  \u6210\u5927\u5fae\u514d\u6240\u78a9\u58eb\uff0c\u66fe\u8457\u6709\u300a\u5716\u89e3\u91ab\u5b78\u300b\u4e00\u66f8\uff0c\u6a02\u65bc\u5c07\u91ab\u5b78\u65b0\u77e5\u4ee5\u6dfa\u767d\u7684<\/span>\u6587\u5b57\u8b93\u66f4\u591a\u4eba\u4e86\u89e3\u3002<\/strong><\/p>\n

     <\/p>\n

    \"\u52a0\u5165\u597d\u53cb\"<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

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