摘要
背景急性心力衰竭(AHF)是高血压急症的常见并发症,具有较高的病死率和致残率,多推荐硝酸甘油、硝普钠或乌拉地尔进行紧急降压治疗,但不同药物的降压效果、对心率的影响及不良反应尚缺少可靠的临床证据。目的比较乌拉地尔与硝普钠治疗高血压急症并AHF患者的临床疗效,为临床指导用药提供科学依据。方法选取2019年2月至2021年1月重庆市第九人民医院收治的高血压急症并AHF患者80例,按照随机数字表法分为对照组和研究组,各40例。患者入院后均给予对症处理,对照组患者采用硝普钠治疗,研究组患者采用乌拉地尔治疗。比较两组患者治疗前、治疗后30 min及治疗后1、2、6 h的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率,记录两组患者治疗期间不良事件(包括药物不良反应、严重不良心脑血管事件)发生情况,并比较研究组不同年龄段(<50岁、50~59岁、60~69岁、70~79岁、≥80岁)患者治疗后2、6 h的SBP、DBP、MAP。结果两组患者治疗前、治疗后30 min及治疗后1、2、6 h SBP、DBP,治疗前、治疗后30 min及治疗后1、6 h MAP,治疗前、治疗后30 min心率比较,差异均无统计学意义(P>0.05)。研究组患者治疗后2 h MAP及治疗后1、2、6 h心率低于对照组(P<0.05)。研究组患者不良事件发生率低于对照组(P<0.05)。研究组不同年龄段患者治疗后2、6 h的SBP、DBP和MAP比较,差异无统计学意义(P>0.05)。结论乌拉地尔与硝普钠均能有效降低高血压急症伴AHF患者的血压,但乌拉地尔降低心率的效果优于硝普钠,其对患者的紧急降压效果与年龄无关,且安全性高。
Background Acute heart failure(AHF)is a common complications of hypertension emergency,with high mortality and disability.Nitroglycerin,sodium nitroprusside or urapidil are recommended for emergency antihypertensive treatment,but there is still a lack of reliable clinical evidence for different drugs on hypotensive effect,heart rate and adverse reactions.Objective To compare the clinical efficacy of urapidil and sodium nitroprusside in the treatment of hypertension emergency complicated with AHF patients,in order to provide a scientific basis for clinical guidance of medication.Methods A total of 80 cases of hypertension emergency complicated with AHF patients were selected in Chongqing Ninth People's Hospital from February 2019 to January 2021.According to random number table method,they were divided into control group and study group,with 40 cases in each group.All patients were treated with symptomatic treatment after admission.The control group was treated with sodium nitroprusside,and the study group was treated with urapidil.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)and heart rate before treatment,30 min after treatment and 1,2,6 h after treatment were compared between the two groups,and incidence of adverse events(including adverse drug reactions,serious adverse cardiovascular and cerebrovascular events)during treatment of the two groups were recorded,and SBP,DBP,MAP 2,6 h after treatment were compared in patients with different age(<50 years old,50-59 years old,60-69 years old,70-79 years old,≥80 years old)in the study group.Results There were no significant differences of SBP,DBP before treatment,30 min after treatment and 1,2,6 h after treatment,MAP before treatment,30 min after treatment and 1,6 h after treatment,heart rate before treatment,30 min after treatment of the two groups(P>0.05).MAP 2 h after treatment,heart rate 1,2,6 h after treatment in the study group were lower than those in the control group(P<0.05).Incidence rate of adverse events in the st
作者
牟钰钦
罗易
李应霞
MOU Yuqin;LUO Yi;LI Yingxia(Department of Pharmacy,Chongqing Ninth People's Hospital,Chongqing 400700,China)
出处
《实用心脑肺血管病杂志》
2021年第9期82-86,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
心力衰竭
高血压
急性心力衰竭
乌拉地尔
硝普钠
疗效比较研究
Heart failure
Hypertension
Acute heart failure
Urapidil
Sodium nitroprusside
Comparative effectiveness research
