不同剂量乌拉地尔对急性缺血性卒中血压和院内时间延误的影响  

The influence of different loading doses of Urapidil injection on blood pressure and the door-to-needle time in acute ischemic stroke

作　　者：陶晓晓[1] 王鹏[1] 金云龙[1] 辛花平[1] 肖雨[1] 郑娴[1] 胡美铃[1] 黄阳萍 叶佳媚[1] 彭霜霜 王俊[1] 王志敏[1] 

机构地区：[1]台州市第一人民医院神经内科脑血管病中心,浙江台州318020

出　　处：《温州医科大学学报》2015年第9期671-673,共3页Journal of Wenzhou Medical University

基　　金：浙江省科技厅公益项目(2014C33258);台州市科技局科技计划项目(081KY31)

摘　　要：目的：探讨不同负荷剂量的乌拉地尔针剂对急性缺血性卒中溶栓前血压控制及其对院内时间（DNT）延误的影响。方法：回顾性分析本院36例接受乌拉地尔降压后经静脉予组织型纤溶酶原激活剂（t-PA）行溶栓治疗的患者,根据负荷剂量分为A、B、C 3组：A组负荷剂量5 mg,B组负荷剂量12.5 mg,C组负荷剂量25 mg。分别比较3组收缩压（SBP）、舒张压（DBP）、DNT及3个月时MRS评分。结果：血压情况：与A组SBP（173.27±6.92）mm Hg、DBP（81.73±7.71）mm Hg比,B组SBP（165.80±7.76）mm Hg、DBP（80.93±6.95）mm Hg和C组SBP（154.80±10.69）mm Hg、DBP（73.60±5.13）mm Hg明显下降,差异有统计学意义（均P〈0.01）;DNT延误：与A组（89.00±25.76）min比,B组（76.73±20.20）min和C组（73.10±14.15）min均明显缩短（均P〈0.01）;3个月时MRS评分（0~1分比例）：与A组（为45.5%）和C组（为50.0%）比,B组（为60.0%）百分比最高,差异有统计学意义（均P〈0.01）。结论：乌拉地尔针剂首剂负荷12.5 mg可有效降压,使血压快速达标,且预后较好。Objective：To observe the effect of different doses of Urapidil injection before thrombolysis in acute ischemic stroke on the blood pressure or door-to-needle time（DNT）.Methods：Thirty-six cases in our hospital who were treated with Urapidil injection before intravenous t-PA treatment were retrospectively analyzed and were divided into 3 groups A,B,C according to the loading dose.Group A was with a loading dose of5 mg Urapidil injection,Group B was with a loading dose of 12.5 mg,and Group C was with a loading dose of25 mg.At last,shrinkage pressure（SBP）,diastolic blood pressure（DBP）,DNT and 3-month MRS score among the three groups were compared.Results：Compared to group A in which SBP was（173.27±6.92） mmHg and DBP（81.73±7.71） mmHg,the blood pressure of group B,with SBP（165.80±7.76） mmHg and DBP（80.93±6.95）mmHg,and group C,with SBP（154.80±10.69） mmHg and DBP（73.60±5.13） mmHg,decreased significantly（P〈0.001）.Compared to group A with（89.00±25.76） min,the DNT of group B with（76.73±20.20） min and group C with（73.10±14.15） min the door-to-needle time（DNT） significantly reduced（P〈0.001）.In addition,the percentage of MRS scores（0-1 points scale） after three months in group B（60.0%） was the highest among the three groups（P〈0.001）.Conclusion：Urapidil injection with the first load of 12.5 mg can effectively decrease blood pressure to standard as soon as possible with a better outcome.

关 键 词：乌拉地尔 缺血性卒中 院内时间延误 静脉溶栓前血压 

分 类 号：R743.32[医药卫生—神经病学与精神病学]