华中科技大学同济医学院附属协和医院 心血管病研究所（武汉 430022）廖玉华

　　摘要 难治性高血压病人由于缺乏或不适当的治疗，经历一个从轻度高血压到中、重度高血压的进展过程，大小动脉重构促进高血压的进展和并发症的发生。本文归纳了难治性高血压的原因，高血压病人需要进行血压、高血压相关血管活性物质和血管重构的监测，分析难治性高血压的影响因素，采取有针对性的降压治疗方案，将会改变难治性高血压的治疗现状。

　　Monitoring and treatment of aiming at causes in refractory hypertension Liao Yuhua Insititute of Cardiology， Union Hospital， Tongji Medical College， Huazhong University of Science & Technology， Wuhan， Chian Refractory hypertension is a progressive process from mild hypertension to moderate， severe hypertension due to absence or inadequate treatment in patients with hypertension. The large and small artery remodeling accelerated the progression of hypertension and complication. The causes of refractory hypertension were summed up. It is necessary that the blood pressure， the vasoactive substance and vessel remodeling were detected in patients with hypertension. Careful， systematic evaluation of patients with refractory hypertension should identify condition and mechanisms of hypertension to targeted therapy. If a depressor plan of aiming at the causes of refractory hypertension was adopted， the treatment condition of refractory hypertension should be changed.