中国高尿酸血症及痛风诊疗指南解读

中国高尿酸血症及痛风诊疗指南解读一、本文概述Overviewofthisarticle本文旨在对《中国高尿酸血症及痛风诊疗指南》进行深入解读，以帮助广大医务工作者和公众更好地理解高尿酸血症及痛风的诊疗规范。高尿酸血症是一种常见的代谢性疾病，而痛风则是其严重并发症之一。随着生活方式的改变和人口老龄化趋势的加剧，高尿酸血症及痛风的发病率逐年上升，对人们的健康造成了严重威胁。因此，制定并推广科学、规范的诊疗指南，对于提高我国高尿酸血症及痛风的诊疗水平，减轻患者痛苦，降低疾病负担具有重要意义。Thisarticleaimstoprovideanin-depthinterpretationoftheChineseGuidelinesfortheDiagnosisandTreatmentofHyperuricemiaandGout,inordertohelphealthcareworkersandthepublicbetterunderstandthediagnosticandtreatmentstandardsforhyperuricemiaandgout.Hyperuricemiaisacommonmetabolicdisease,andgoutisoneofitsseriouscomplications.Withthechangeoflifestyleandtheaggravationoftheagingtrendofthepopulation,theincidencerateofhyperuricemiaandgouthasincreasedyearbyyear,posingaseriousthreattopeople'shealth.Therefore,developingandpromotingscientificandstandardizeddiagnosisandtreatmentguidelinesisofgreatsignificanceforimprovingthediagnosisandtreatmentlevelofhyperuricemiaandgoutinChina,reducingpatientsuffering,andreducingdiseaseburden.《中国高尿酸血症及痛风诊疗指南》是在广泛收集国内外高尿酸血症及痛风诊疗研究的基础上，结合我国实际情况制定的权威指南。该指南详细介绍了高尿酸血症及痛风的定义、流行病学特征、发病机制、临床表现、诊断方法、治疗策略等方面的内容，为医务工作者提供了全面、系统的诊疗参考。TheChineseGuidelinesfortheDiagnosisandTreatmentofHyperuricemiaandGoutareauthoritativeguidelinesdevelopedbasedonextensivecollectionofresearchonthediagnosisandtreatmentofhyperuricemiaandgoutbothdomesticallyandinternationally,combinedwiththeactualsituationinChina.Thisguideprovidesadetailedintroductiontothedefinition,epidemiologicalcharacteristics,pathogenesis,clinicalmanifestations,diagnosticmethods,treatmentstrategies,andotheraspectsofhyperuricemiaandgout,providingcomprehensiveandsystematicdiagnosisandtreatmentreferencesformedicalworkers.本文将对《中国高尿酸血症及痛风诊疗指南》中的关键内容进行详细解读，包括高尿酸血症及痛风的诊断标准、治疗原则、药物治疗和非药物治疗等方面的内容。还将结合最新的研究进展和临床实践，对指南中的推荐意见进行深入分析，以期为广大医务工作者提供更为全面、深入的诊疗指导。通过本文的解读，我们希望能够提高公众对高尿酸血症及痛风的认识，促进疾病的早期发现和治疗，为保障人们的健康贡献力量。ThisarticlewillprovideadetailedinterpretationofthekeycontentintheChineseGuidelinesfortheDiagnosisandTreatmentofHyperuricemiaandGout,includingdiagnosticcriteria,treatmentprinciples,medicationandnonmedicationtreatmentsforhyperuricemiaandgout.Wewillalsoconductin-depthanalysisoftherecommendationsintheguidelinesbasedonthelatestresearchprogressandclinicalpractice,inordertoprovidemorecomprehensiveandin-depthdiagnosisandtreatmentguidanceforhealthcareworkers.Throughtheinterpretationofthisarticle,wehopetoincreasepublicawarenessofhyperuricemiaandgout,promoteearlydetectionandtreatmentofdiseases,andcontributetoensuringpeople'shealth.二、高尿酸血症的诊断标准与治疗策略Diagnosticcriteriaandtreatmentstrategiesforhyperuricemia高尿酸血症是指血液中尿酸浓度超过正常范围的一种代谢性疾病，其诊断标准通常基于血液尿酸浓度的测量值。在我国，成年男性血尿酸浓度超过420μmol/L，成年女性超过360μmol/L，即可诊断为高尿酸血症。然而，这一标准并非绝对，对于不同人群（如老年人、患有肾脏疾病等）可能需要调整。Hyperuricemiareferstoametabolicdisorderinwhichtheconcentrationofuricacidinthebloodexceedsthenormalrange,anditsdiagnosticcriteriaareusuallybasedonmeasurementsofblooduricacidconcentration.InChina,theblooduricacidconcentrationinadultmalesexceeds420%μMol/L,adultfemalesexceeding360μMol/Lcanbeusedtodiagnosehyperuricemia.However,thisstandardisnotabsoluteandmayneedtobeadjustedfordifferentpopulations,suchastheelderlyandthosewithkidneydisease.治疗高尿酸血症的策略主要包括生活方式干预和药物治疗。生活方式干预是基础且长期的治疗手段，包括饮食调整（减少高嘌呤食物摄入，增加水果、蔬菜摄入等）、增加运动、控制体重、戒烟限酒等。这些措施有助于降低血尿酸水平，减少痛风发作的风险。Thestrategiesfortreatinghyperuricemiamainlyincludelifestyleinterventionandmedicationtreatment.Lifestyleinterventionisafundamentalandlong-termtreatmentapproach,includingdietaryadjustments(reducinghighpurinefoodintake,increasingfruitandvegetableintake,etc.),increasingexercise,controllingweight,quittingsmokingandlimitingalcoholconsumption,etc.Thesemeasureshelptoreduceblooduricacidlevelsandreducetheriskofgoutattacks.在药物治疗方面，主要使用降尿酸药物，如别嘌醇、丙磺舒等。这些药物通过抑制尿酸合成或促进尿酸排泄来降低血尿酸水平。然而，药物治疗应在医生指导下进行，根据患者的具体情况选择合适的药物和剂量。Intermsofdrugtreatment,uricacidloweringdrugssuchasallopurinolandprobenecidaremainlyused.Thesedrugslowerblooduricacidlevelsbyinhibitinguricacidsynthesisorpromotinguricacidexcretion.However,drugtherapyshouldbecarriedoutundertheguidanceofadoctor,selectingappropriatedrugsanddosesbasedonthespecificsituationofthepatient.对于伴有痛风的高尿酸血症患者，还应采取针对痛风的治疗措施，如使用非甾体抗炎药、糖皮质激素等药物缓解疼痛和炎症。也应关注高尿酸血症可能引起的其他并发症，如心血管疾病、肾脏疾病等，并采取相应的治疗措施。Forpatientswithhyperuricemiaaccompaniedbygout,targetedtreatmentmeasuresshouldalsobetaken,suchasusingnonsteroidalanti-inflammatorydrugs,glucocorticoids,andotherdrugstoalleviatepainandinflammation.Attentionshouldalsobepaidtoothercomplicationsthathyperuricemiamaycause,suchascardiovasculardisease,kidneydisease,etc.,andcorrespondingtreatmentmeasuresshouldbetaken.高尿酸血症的诊断和治疗需要综合考虑患者的具体情况，制定个体化的治疗方案。通过生活方式干预和药物治疗的综合应用，可以有效控制高尿酸血症的发展，减少痛风发作的风险，提高患者的生活质量。Thediagnosisandtreatmentofhyperuricemiarequirecomprehensiveconsiderationofthepatient'sspecificsituationandthedevelopmentofpersonalizedtreatmentplans.Thecomprehensiveapplicationoflifestyleinterventionanddrugtherapycaneffectivelycontrolthedevelopmentofhyperuricemia,reducetheriskofgoutattacks,andimprovethequalityoflifeofpatients.三、痛风的诊断标准与治疗策略Diagnosticcriteriaandtreatmentstrategiesforgout痛风的诊断主要依据患者的临床表现、实验室检查以及影像学检查。在临床表现上，痛风患者常出现突然发作的关节红肿热痛，常见于大脚趾、脚踝、膝关节等部位。实验室检查方面，患者的血尿酸水平通常会升高，且在关节炎发作时，关节液或痛风石中可发现尿酸盐结晶。影像学检查如超声检查、双能CT等可发现关节内或关节周围的尿酸盐沉积。Thediagnosisofgoutismainlybasedonthepatient'sclinicalmanifestations,laboratorytests,andimagingexaminations.Inclinicalmanifestations,goutpatientsoftenexperiencesuddenonsetofjointredness,swelling,heatandpain,commonlyfoundinareassuchasthebigtoe,ankle,andkneejoint.Intermsoflaboratorytests,thepatient'sblooduricacidlevelisusuallyelevated,anduratecrystalscanbefoundinthejointfluidorgoutstonesduringtheonsetofarthritis.ImagingexaminationssuchasultrasoundanddualenergyCTcandetecturatedepositswithinoraroundthejoints.痛风的治疗策略主要包括急性期治疗、间歇期治疗和慢性期治疗。在急性期，治疗的主要目标是快速控制关节炎症状，减轻患者痛苦。常用的药物包括非甾体抗炎药（NSAIDs）、秋水仙碱和糖皮质激素等。在间歇期和慢性期，治疗的主要目标是降低血尿酸水平，预防痛风发作，保护肾功能。常用的药物包括别嘌醇、丙磺舒、苯溴马隆等降尿酸药物。Thetreatmentstrategiesforgoutmainlyincludeacutephasetreatment,intermittentphasetreatment,andchronicphasetreatment.Intheacutephase,themaingoaloftreatmentistoquicklycontrolthesymptomsofarthritisandalleviatepatientpain.Commonlyuseddrugsincludenonsteroidalanti-inflammatorydrugs(NSAIDs),colchicine,andglucocorticoids.Duringtheintermittentandchronicperiods,themaingoaloftreatmentistoreduceblooduricacidlevels,preventgoutattacks,andprotectkidneyfunction.Commonlyuseddrugsincludeuricacidloweringdrugssuchasallopurinol,probenecid,andbenzbromarone.生活方式的调整也是痛风治疗的重要组成部分。患者应避免高嘌呤饮食，如动物内脏、海鲜等，限制饮酒，保持充足的水分摄入，以促进尿酸的排泄。适当的运动也有助于控制体重，改善代谢，降低痛风发作的风险。Adjustinglifestyleisalsoanimportantcomponentofgouttreatment.Patientsshouldavoidhighpurinedietssuchasanimalorgansandseafood,limitalcoholconsumption,andmaintainsufficientwaterintaketopromoteuricacidexcretion.Properexercisecanalsohelpcontrolweight,improvemetabolism,andreducetheriskofgoutattacks.痛风的诊断和治疗需要综合考虑患者的临床表现、实验室检查和影像学检查等多方面的信息。在治疗上，应根据患者的具体情况制定个性化的治疗方案，既要控制急性期症状，又要注重降低血尿酸水平，预防痛风发作，保护肾功能。生活方式的调整也是治疗的重要环节。Thediagnosisandtreatmentofgoutrequirecomprehensiveconsiderationofthepatient'sclinicalmanifestations,laboratorytests,andimagingexaminations.Intermsoftreatment,personalizedtreatmentplansshouldbedevelopedbasedonthespecificsituationofthepatient.Itisimportanttocontrolacutesymptomswhilealsopayingattentiontoreducingblooduricacidlevels,preventinggoutattacks,andprotectingkidneyfunction.Adjustinglifestyleisalsoanimportantpartoftreatment.四、高尿酸血症与痛风的并发症预防与管理Preventionandmanagementofcomplicationsofhyperuricemiaandgout高尿酸血症和痛风不仅影响患者的生活质量，还可能引发一系列严重的并发症。因此，对于这两种疾病的并发症预防与管理至关重要。Hyperuricemiaandgoutnotonlyaffectthequalityoflifeofpatients,butmayalsoleadtoaseriesofseriouscomplications.Therefore,itiscrucialtopreventandmanagethecomplicationsofthesetwodiseases.高尿酸血症和痛风患者常伴有心血管疾病的风险增加。因此，应定期进行心血管健康检查，包括血压、血脂、血糖等指标的监测。同时，提倡健康的生活方式，如合理饮食、适度运动、戒烟限酒等，以降低心血管疾病的发生率。Patientswithhyperuricemiaandgoutoftenhaveanincreasedriskofcardiovasculardisease.Therefore,regularcardiovascularhealthchecksshouldbeconducted,includingmonitoringofindicatorssuchasbloodpressure,bloodlipids,andbloodsugar.Atthesametime,promotingahealthylifestyle,suchasreasonablediet,moderateexercise,smokingcessationandalcoholrestriction,toreducetheincidenceofcardiovasculardisease.高尿酸血症和痛风可能对肾功能造成损害。因此，患者应定期进行肾功能检查，如血肌酐、尿素氮、尿酸等指标的监测。在药物治疗方面，应避免使用可能损害肾功能的药物，如利尿剂等。同时，保持良好的水分摄入，促进尿酸的排泄，有助于保护肾功能。Hyperuricemiaandgoutmaycausedamagetorenalfunction.Therefore,patientsshouldundergoregularrenalfunctiontests,suchasmonitoringindicatorssuchasbloodcreatinine,ureanitrogen,anduricacid.Intermsofdrugtherapy,theuseofdrugsthatmaydamagerenalfunction,suchasdiuretics,shouldbeavoided.Meanwhile,maintaininggoodwaterintakepromotestheexcretionofuricacid,whichhelpstoprotectkidneyfunction.高尿酸血症和痛风患者常伴有糖尿病的风险增加。因此，对于这类患者应进行定期的血糖监测，及时发现并治疗糖尿病。在药物治疗方面，应根据患者的具体情况选择合适的降糖药物，同时配合饮食控制和运动疗法，以维持血糖在正常水平。Patientswithhyperuricemiaandgoutoftenhaveanincreasedriskofdiabetes.Therefore,regularbloodglucosemonitoringshouldbecarriedoutforsuchpatientstodetectandtreatdiabetesintime.Intermsofmedicationtreatment,appropriatehypoglycemicdrugsshouldbeselectedbasedonthespecificsituationofthepatient,whilealsocooperatingwithdietarycontrolandexercisetherapytomaintainbloodsugarlevelsatnormallevels.痛风性关节炎是高尿酸血症和痛风的主要并发症之一。在急性发作期，应及时给予抗炎止痛药物，如非甾体抗炎药、糖皮质激素等，以缓解疼痛和炎症。在间歇期，应进行长期的降尿酸治疗，以预防痛风性关节炎的反复发作。患者还应避免诱发因素，如过度劳累、寒冷刺激等，以降低痛风性关节炎的发生率。Goutyarthritisisoneofthemaincomplicationsofhyperuricemiaandgout.Duringacuteattacks,timelyadministrationofanti-inflammatoryandanalgesicdrugs,suchasnonsteroidalanti-inflammatorydrugs,glucocorticoids,etc.,shouldbeadministeredtoalleviatepainandinflammation.Duringtheintermittentperiod,long-termuricacidloweringtreatmentshouldbecarriedouttopreventtherecurrenceofgoutyarthritis.Patientsshouldalsoavoidtriggeringfactorssuchasoverwork,coldstimulation,etc.toreducetheincidenceofgoutyarthritis.对于高尿酸血症和痛风患者，并发症的预防与管理是综合治疗的重要组成部分。通过定期的健康检查、药物治疗和生活方式调整，可以有效降低并发症的发生率，提高患者的生活质量。Forpatientswithhyperuricemiaandgout,thepreventionandmanagementofcomplicationsareimportantcomponentsofcomprehensivetreatment.Regularhealthchecks,medicationtreatment,andlifestyleadjustmentscaneffectivelyreducetheincidenceofcomplicationsandimprovethequalityoflifeofpatients.五、高尿酸血症与痛风的健康教育与生活方式干预Healtheducationandlifestyleinterventionforhyperuricemiaandgout高尿酸血症和痛风是一种与生活方式密切相关的疾病，因此，对患者进行健康教育和生活方式干预是预防和治疗该病的重要手段。Hyperuricemiaandgoutarecloselyrelatedtolifestyle,therefore,providinghealtheducationandlifestyleinterventionstopatientsisanimportantmeansofpreventingandtreatingthisdisease.饮食教育：教育患者理解低嘌呤饮食的重要性，并教授他们如何识别和选择低嘌呤食物。同时，减少高嘌呤食物，如动物内脏、海鲜、红肉等的摄入。增加蔬菜、水果和全谷物的摄入，以提供丰富的维生素和纤维，有助于降低尿酸水平和控制体重。Dietaryeducation:Educatepatientstounderstandtheimportanceofalowpurinedietandteachthemhowtoidentifyandchooselowpurinefoods.Atthesametime,reducetheintakeofhighpurinefoodssuchasanimalorgans,seafood,redmeat,etc.Increasingtheintakeofvegetables,fruits,andwholegrainstoprovideabundantvitaminsandfibercanhelpreduceuricacidlevelsandcontrolweight.体重管理：超重和肥胖是高尿酸血症和痛风的重要风险因素。因此，教育患者理解保持健康体重的重要性，并通过合理的饮食和增加身体活动来达到或维持理想体重。Weightmanagement:Overweightandobesityareimportantriskfactorsforhyperuricemiaandgout.Therefore,educatingpatientstounderstandtheimportanceofmaintainingahealthyweightandachievingormaintaininganidealweightthroughreasonabledietandincreasedphysicalactivity.规律运动：适量的运动可以帮助患者控制体重，增强身体素质，提高尿酸的排泄率。建议患者进行规律的有氧运动，如快走、慢跑、游泳等，但避免剧烈运动，因为剧烈运动可能会诱发痛风发作。Regularexercise:Moderateexercisecanhelppatientscontroltheirweight,improvephysicalfitness,andincreasetheexcretionrateofuricacid.Itisrecommendedthatpatientsengageinregularaerobicexercise,suchasbriskwalking,jogging,swimming,etc.,butavoidvigorousexerciseasitmaytriggergoutattacks.酒类摄入限制：酒类，尤其是啤酒和烈酒，会促进尿酸的产生和抑制尿酸的排泄，从而增加高尿酸血症和痛风的风险。因此，建议患者限制或避免酒类摄入。Alcoholintakerestriction:Alcohol,especiallybeerandspirits,canpromotetheproductionofuricacidandinhibititsexcretion,therebyincreasingtheriskofhyperuricemiaandgout.Therefore,itisrecommendedthatpatientslimitoravoidalcoholintake.戒烟：吸烟与痛风的发生和发展有密切关系，因此，鼓励患者戒烟，以降低痛风的风险。Quittingsmoking:Smokingiscloselyrelatedtotheoccurrenceanddevelopmentofgout,therefore,patientsareencouragedtoquitsmokingtoreducetheriskofgout.心理健康：高尿酸血症和痛风可能会给患者的生活带来困扰，影响他们的心理健康。因此，对患者进行心理健康教育，帮助他们建立积极的生活态度，对疾病的控制和治疗有重要的促进作用。Psychologicalhealth:Hyperuricemiaandgoutmaycausedifficultiesinthelivesofpatients,affectingtheirmentalhealth.Therefore,providingpsychologicalhealtheducationtopatients,helpingthemestablishapositiveattitudetowardslife,hasanimportantpromotingeffectondiseasecontrolandtreatment.对于高尿酸血症和痛风的患者，健康教育与生活方式干预是不可或缺的一部分。通过合理的饮食、适当的运动、良好的生活习惯和积极的心态，患者可以有效地控制疾病，提高生活质量。Forpatientswithhyperuricemiaandgout,healtheducationandlifestyleinterventionsareanindispensablepart.Throughreasonablediet,appropriateexercise,goodlifestylehabits,andapositiveattitude,patientscaneffectivelycontroltheirdiseasesandimprovetheirqualityoflife.六、诊疗指南的更新与未来展望UpdateandFutureProspectsofDiagnosisandTreatmentGuidelines随着高尿酸血症及痛风诊疗领域的科学研究与临床实践的不断深入，诊疗指南的更新显得尤为重要。近年来，国内外专家在高尿酸血症及痛风的发病机制、诊断方法、治疗策略等方面取得了显著的进展，这为诊疗指南的更新提供了有力的科学依据。Withthecontinuousdeepeningofscientificresearchandclinicalpracticeinthediagnosisandtreatmentofhyperuricemiaandgout,theupdatingofdiagnosisandtreatmentguidelineshasbecomeparticularlyimportant.Inrecentyears,domesticandforeignexpertshavemadesignificantprogressinthepathogenesis,diagnosticmethods,andtreatmentstrategiesofhyperuricemiaandgout,providingstrongscientificbasisfortheupdatingofdiagnosticandtreatmentguidelines.诊疗指南的更新应关注高尿酸血症及痛风的新发病机制和病理生理过程。例如，近年来对于尿酸代谢相关基因的研究，以及高尿酸血症与心血管疾病、慢性肾脏病等相关性的深入探索，都为诊疗指南的更新提供了重要的理论基础。Theupdateofdiagnosticandtreatmentguidelinesshouldfocusonthenewpathogenesisandpathophysiologicalprocessesofhyperuricemiaandgout.Forexample,inrecentyears,researchongenesrelatedtouricacidmetabolism,aswellasin-depthexplorationofthecorrelationbetweenhyperuricemiaandcardiovasculardisease,chronickidneydisease,etc.,haveprovidedimportanttheoreticalfoundationsfortheupdatingofdiagnosticandtreatmentguidelines.新的诊断技术和方法的出现也为诊疗指南的更新提供了可能。例如，尿酸水平的精准检测、关节液及滑膜组织的检查、影像学检查等技术的发展，使得高尿酸血症及痛风的诊断更加准确和全面。Theemergenceofnewdiagnostictechnologiesandmethodshasalsoprovidedpossibilitiesfortheupdatingofdiagnosticandtreatmentguidelines.Forexample,thedevelopmentofprecisedetectionofuricacidlevels,examinationofjointfluidandsynovialtissue,imagingexaminations,andothertechnologieshasmadethediagnosisofhyperuricemiaandgoutmoreaccurateandcomprehensive.治疗策略的不断优化也是诊疗指南更新的重要内容。目前，高尿酸血症及痛风的治疗已经从单一的降尿酸治疗发展到综合治疗，包括生活方式调整、药物治疗、手术治疗等多种手段。未来，随着新型药物的研发和应用，以及个体化治疗理念的推广，诊疗指南将更加注重治疗策略的多样性和个性化。Thecontinuousoptimizationoftreatmentstrategiesisalsoanimportantaspectofupdatingdiagnosticandtreatmentguidelines.Atpresent,thetreatmentofhyperuricemiaandgouthasevolvedfromasingleuricacidloweringtreatmenttocomprehensivetreatment,includinglifestyleadjustments,drugtherapy,surgicaltreatment,andothermethods.Inthefuture,withthedevelopmentandapplicationofnewdrugs,aswellasthepromotionofpersonalizedtreatmentconcepts,diagnosticandtreatmentguidelineswillpaymoreattentiontothediversityandpersonalizationoftreatmentstrategies.展望未来，高尿酸血症及痛风的诊疗指南将继续关注发病机制、诊断技术、治疗策略等方面的研究进展，不断完善和更新，以更好地指导临床实践，提高高尿酸血症及痛风的诊疗水平，为广大患者提供更优质的医疗服务。我们也期待更多的科研工作者和临床医生参与到高尿酸血症及痛风的诊疗指南制定和更新中来，共同推动该领域的发展。Lookingaheadtothefuture,thediagnosisandtreatmentguidelinesforhyperuricemiaandgoutwillcontinuetofocusonresearchprogressinpathogenesis,diagnostictechniques,treatmentstrategies,andotheraspects,continuouslyimprovingandupdatingtobetterguideclinicalpractice,improvethediagnosisandtreatmentlevelofhyperuricemiaandgout,andprovidebettermedicalservicesforpatients.Wealsolookforwardtomoreresearchersandclinicaldoctorsparticipatinginthedevelopmentandupdatingofdiagnosticandtreatmentguidelinesforhyperuricemiaandgout,tojointlypromotethedevelopmentofthisfield.七、结论Conclusion通过对《中国高尿酸血症及痛风诊疗指南》的深入解读，我们可以明确高尿酸血症及痛风的诊疗策略与原则。本指南的发布不仅为临床医生提供了科学、规范的诊疗依据，也为患者提供了更好的疾病管理方案。Throughin-depthinterpretationoftheChineseGuidelinesfortheDiagnosisandTreatmentofHyperuricemiaandGout,wecanclarifythediagnosisandtreatmentstrategiesandprinciplesforhyperuricemiaandgout.Thereleaseofthisguidelinenotonlyprovidesscientificandstandardizeddiagnosisandtreatmentbasisforclinicaldoctors,butalsoprovidesbetterdiseasemanagementplansforpatients.对于高尿酸血症的诊断与管理，指南强调了生活方式干预的重要性，包括健康饮食、规律运动、控制体重和限制酒精摄入等。同时，对于需要药物治疗的患者，指南也提供了详尽的用药建议，以确保患者能够得到安全、有效的治疗。Forthediagnosisandmanagementofhyp