硝普钠与乌拉地尔联合交替应用治疗高血压急症的疗效观察(1)
[摘要] 目的 观察单独静脉注射硝普钠与乌拉地尔及二者交替应用治疗高血压急症的疗效。 方法 将126例高血压危象患者随机分为3组：硝普钠组47例，乌拉地尔组38例，二者联合交替应用组41例，3组在常规治疗基础上分别静脉给予硝普钠、乌拉地尔及二者交替应用，观察3组患者疗效及各项副反应情况。 结果 硝普钠组、乌拉地尔组及二者联合交替应用组3组控制血压方面差异无统计学意义(P > 0.05)，用药后硝普钠组与乌拉地尔组及二者联合交替应用组相比心率下降较少，差异具有统计学意义(P < 0.05)。 结论 3组治疗高血压危象均有效、安全、迅速，二者联合交替应用不良反应小，疗效明确，费用较低。
[关键词] 高血压危象；硝普钠；乌拉地尔；疗效观察
[中图分类号] R972+.4 [文献标识码] A [文章编号] 1674-4721(2012)06(a)-0077-02
, 百拇医药 Efficacy observation of sodium nitroprusside and urapidil combined alternative treatment of hypertensive emergencies
WANG Dongwei
Heart 1st Division, Zhengzhou Central Hospital in Henan Province, Zhengzhou 450007, China
[Abstract] Objective To observe the efficacy of single intravenous injection of sodium nitroprusside and urapidil and two alternate treatment of hypertensive emergencies. Methods One hundred and twenty six patients with hypertensive emergencies were randomly divided into three groups, sodium nitroprusside group (A group) 47cases, urapidil group (B group) 38 cases, and combination of alternating application group (C group) 41 cases. In the conventional therapy three groups were respectively given sodium nitroprusside, urapidil and two alternate intravenously, the side effects and situation was observed in the three groups of patients. Results The total effective rate of A group, B group and C group had no significant difference (P > 0.05). After treatment, the heart rate of A group, B group and C group decreased, moreover with significant difference (P < 0.05). Conclusion It is effective, safe and fast that three groups of treatment of hypertensive emergencies, but sodium nitroprusside, and alternating urapidil combined application has lower adverse reaction and costs.
, 百拇医药
[Key words] Hypertensive emergencies; Sodium nitroprusside; Urapidil; Efficacy observation
高血压急症(hypertensive emergencies)是心血管科常见急症之一，多数病情危重，但如果治疗及时，绝大部分患者可转危为安，目前硝普钠及乌拉地尔均为治疗高血压急症常用有效药，但二者联合交替应用效果尚未见报道。为此，笔者对于2007年1月～2009年7月入住本院心内科的患者，通过随机分组，观察了二者联合交替应用对高血压急症的疗效及安全性。具体如下：
1 资料及方法
1.1 一般资料
入选患者均为2007年1月～2009年7月入住本院心内科高血压急症患者，诊断均符合中国高血压防治指南修订委员会制定的中国高血压防治指南标准[1]，高血压急症的特点是血压严重升高(BP > 180/120 mm Hg)并伴发进行性靶器官功能不全的表现。3组患者均排除动静脉分流及主动脉缩窄。随机分为硝普钠组(A组)、乌拉地尔组(B组)及二者联合交替应用组(C组)。3组患者年龄、性别、病情分类上差异均无统计学意义(P > 0.05)。见表1。
, 百拇医药
1.2 治疗方法
所有患者均常在规吸氧，监测心电、血压，去除诱因、休息、限制钠盐，同时予以相应疾病基础治疗基础上，硝普钠50~100 mg加入0.9%氯化钠溶液或5%葡萄糖50 mL，以0.5 μg/(kg·min)为初始剂量泵入，每5分钟调整一次剂量，最大剂量用至10 μg/(kg·min)。盐酸乌拉地尔注射液(商品名：利喜定)12.5 mg加5%葡萄糖20 mL静脉注射，继之以50~100 mg加入0.9%氯化钠溶液或5%葡萄糖50 mL按2~12 μg/(kg·min)持续泵入，依据血压调整速度。二者联合应用时，先应用硝普钠(方法同上)6 h，继而应用盐酸乌拉地尔直接2~12 ug/(kg·min)静脉泵入，维持6 h，反复交替应用硝普钠及乌拉地尔。比较用药前及用药后24 h心率及血压变化。, 百拇医药(王东伟)
[关键词] 高血压危象；硝普钠；乌拉地尔；疗效观察
[中图分类号] R972+.4 [文献标识码] A [文章编号] 1674-4721(2012)06(a)-0077-02
, 百拇医药 Efficacy observation of sodium nitroprusside and urapidil combined alternative treatment of hypertensive emergencies
WANG Dongwei
Heart 1st Division, Zhengzhou Central Hospital in Henan Province, Zhengzhou 450007, China
[Abstract] Objective To observe the efficacy of single intravenous injection of sodium nitroprusside and urapidil and two alternate treatment of hypertensive emergencies. Methods One hundred and twenty six patients with hypertensive emergencies were randomly divided into three groups, sodium nitroprusside group (A group) 47cases, urapidil group (B group) 38 cases, and combination of alternating application group (C group) 41 cases. In the conventional therapy three groups were respectively given sodium nitroprusside, urapidil and two alternate intravenously, the side effects and situation was observed in the three groups of patients. Results The total effective rate of A group, B group and C group had no significant difference (P > 0.05). After treatment, the heart rate of A group, B group and C group decreased, moreover with significant difference (P < 0.05). Conclusion It is effective, safe and fast that three groups of treatment of hypertensive emergencies, but sodium nitroprusside, and alternating urapidil combined application has lower adverse reaction and costs.
, 百拇医药
[Key words] Hypertensive emergencies; Sodium nitroprusside; Urapidil; Efficacy observation
高血压急症(hypertensive emergencies)是心血管科常见急症之一，多数病情危重，但如果治疗及时，绝大部分患者可转危为安，目前硝普钠及乌拉地尔均为治疗高血压急症常用有效药，但二者联合交替应用效果尚未见报道。为此，笔者对于2007年1月～2009年7月入住本院心内科的患者，通过随机分组，观察了二者联合交替应用对高血压急症的疗效及安全性。具体如下：
1 资料及方法
1.1 一般资料
入选患者均为2007年1月～2009年7月入住本院心内科高血压急症患者，诊断均符合中国高血压防治指南修订委员会制定的中国高血压防治指南标准[1]，高血压急症的特点是血压严重升高(BP > 180/120 mm Hg)并伴发进行性靶器官功能不全的表现。3组患者均排除动静脉分流及主动脉缩窄。随机分为硝普钠组(A组)、乌拉地尔组(B组)及二者联合交替应用组(C组)。3组患者年龄、性别、病情分类上差异均无统计学意义(P > 0.05)。见表1。
, 百拇医药
1.2 治疗方法
所有患者均常在规吸氧，监测心电、血压，去除诱因、休息、限制钠盐，同时予以相应疾病基础治疗基础上，硝普钠50~100 mg加入0.9%氯化钠溶液或5%葡萄糖50 mL，以0.5 μg/(kg·min)为初始剂量泵入，每5分钟调整一次剂量，最大剂量用至10 μg/(kg·min)。盐酸乌拉地尔注射液(商品名：利喜定)12.5 mg加5%葡萄糖20 mL静脉注射，继之以50~100 mg加入0.9%氯化钠溶液或5%葡萄糖50 mL按2~12 μg/(kg·min)持续泵入，依据血压调整速度。二者联合应用时，先应用硝普钠(方法同上)6 h，继而应用盐酸乌拉地尔直接2~12 ug/(kg·min)静脉泵入，维持6 h，反复交替应用硝普钠及乌拉地尔。比较用药前及用药后24 h心率及血压变化。, 百拇医药(王东伟)