硝酸酯类静脉滴注速度对冠心病患者血压的影响  

Influence of drip velocity of nitrate on blood pressure of patients with coronary heart disease

作　　者：杨瑞兰[1] 任振环[1] 任慧敏[1] 李苗苗[1] 毛巧玲[1] 闫喜英[1] 岳晓云[1] 

机构地区：[1]新乡医学院第二附属医院心内科,453002

出　　处：《中国实用护理杂志》2012年第20期19-21,共3页Chinese Journal of Practical Nursing

摘　　要：目的探讨静脉应用硝酸酯类治疗冠心病时不同给药速度与血压的关系，为临床制定适宜的给药速度提供依据。方法收集应用硝酸酯类降压的冠心病患者155例，依据治疗药物的不同分为硝酸甘油组85例和单硝酸异山梨酯组70例。对2组患者均根据血压调整给药速度，观察并比较不同滴注速度时2组患者血压的变化。结果以20滴／min的速度滴注时，2组间的收缩压和舒张压比较差异无统计学意义。而以30滴／min的速度滴注时，2组间的收缩压和舒张压比较差异均有统计学意义。硝酸甘油组不同滴速下的收缩压和舒张压均有显著的变化，而单硝酸异山梨酯组这种变化并不显著。硝酸甘油组9例用药过程中出现头痛。单硝酸异山梨酯组无头痛发生，2组血压升高。结论静脉应用硝酸酯类药物以20μg／min（相当于20滴，min）相对安全，再增加给药速度发生低血压的风险增加。单硝酸异山梨酯静脉滴注对血压影响较小。Objective To discuss the relationship of drip velocity of nitrate on blood pressure while treating coronary disease,in order to provide appropriate drip velocity for clinical treatment. Methods 155 patients with coronary disease using nitrate to lower blood pressure were selected. They were divided into the nitro glycerin group（85 cases） and the isosorbide mononitrate group（ 70 cases） according to difference of medication. The velocity of drugs was adjusted on basis of blood pressure changes. The blood pressure changes at different drip velocities were observed and compared. Results The systolic pressure and the diastolic pressure between two groups showed no difference at 20 drops/min, but the results were the opposite at 30 drops/min. The systolic pressure and the diastolic pressure in the nitro glycerin group showed evident changes at different drip velocities, but in the isosorbide mononitrate group, these changes were not so significant. 9 patients in the nitro glycerin group had headache during treatment, no headache occurred in the isosorbide mononitrate group. Conclusions Intravenous use of nitrate at a velocity of 20 drops/min is relative secure. The risk of hypotension will increase if the medication speed increases. Isosorbide mononitrate has little influence on blood pressure.

关 键 词：硝酸甘油 单硝酸异山梨酯 冠心病 收缩压 舒张压 

分 类 号：R541.4[医药卫生—心血管疾病]