艾司洛尔联合尼卡地平治疗急性主动脉夹层的疗效观察  

Clinical observation of esmolol hydrochloride combined with nicardipine in the treatment of acute aortic dissection

作　　者：窦武宇[1,2] 黄山松[1] 蒋建刚[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,湖北武汉430030 [2]甘肃省华亭煤业集团总医院,甘肃平凉744100

出　　处：《中国医院药学杂志》2013年第20期1703-1705,共3页Chinese Journal of Hospital Pharmacy

基　　金：973计划项目(编号:2012CB517801-2)

摘　　要：目的:评价艾司洛尔联合尼卡地平控制急性主动脉夹层患者的疗效。方法:回顾性分析86例急性主动脉夹层患者,按照所用药物分为尼卡地平组(30例)和尼卡地平联合艾司洛尔组(56例),分别接受尼卡地平,或艾司洛尔联合尼卡地平静脉注射治疗。观察治疗后各时间段的胸痛、血压和心率变化情况。结果:尼卡地平联合艾司洛尔治疗30 min后胸痛缓解率达42.8%,6 h缓解率达66%;治疗10 min后血压和心率即明显下降,治疗后各时间点收缩压、舒张压和心率与治疗前比较均明显下降(P<0.05),治疗30 min后达血压心率标率为71%,治疗60 min后达标率为92.3%,6 h后达标率为100%明显高于单用尼卡地平组。2组治疗前后肝肾功能无明显变化。尼卡地平组出现低血压2例,艾司洛尔联合尼卡地平组出现低血压和静脉炎各2例,在降低药物剂量后血压和心率很快恢复正常。结论:艾司洛尔联合尼卡地平可以快速、有效、安全地控制急性主动脉夹层患者的血压和心率。OBJECTIVE To evaluate the effects of esmolol hydrochloride combined with nicardipine in control of acute aortic dissection. METHODS 86 patients with acute aortic dissection were divided into nicardipine group （30 case） and esmolol hydrochloride combined with nicardipine group （56 case）. Chest pain, blood pressure and heart rate were observed at each time point after treatment. RESULTS In esmolol hydrochloride combined with nicardipine group, the chest pain remission rate was 42. 8% after 60rain treatment and 66 % after 6 h treatment. Blood pressure and heart rate began to decrease 10 rain after treat ment. Blood pressure and heart rate were decreased significantly after administration at each time point, compared with before treatment （P〈0. 05）. The rate of reached treatment goal was 7l %, 92.3% and 100% at 30min, 60 min and 6 h after adminis- tration, respectively. The effects of esmolol hydrochloride combined with nicardipine group were better than those of nieardip ine group （P〈0. 05）. Any damage for live and kidney functions were not observed. 2 cases hypotension were noticed in nicar- dipine group. 2 cases with hypotension and phlebitis were noticed in esmolol hydrochloride combined with nicardipine group （2/ 56）. But blood pressure and phlebitis returned to the normal after administrating speed being slowed down. CONCLUSION Intravenous esmolol hydrochloride combined with nicardipine can quickly, effectively and safely control blood pressure and heart rate in acute aortic dissection patients.

关 键 词：艾司洛尔 尼卡地平 主动脉夹层 

分 类 号：R969[医药卫生—药理学]