乌拉地尔与硝普钠治疗急性主动脉夹层高血压的临床研究  

A clinical study to compare the effect of Urapidil and Sodium Nitroprusside on the treatment of aortic dissection hypertensive crisis

作　　者：赵鹏[1] 黄杨[1] 余厚友[1] 尹文[1] 

机构地区：[1]第四军医大学西京医院急诊科,西安710032

出　　处：《临床急诊杂志》2015年第12期920-922,共3页Journal of Clinical Emergency

摘　　要：目的:探讨在急诊治疗急性主动脉夹层患者高血压时α1受体阻滞剂乌拉地尔的降压效果是否优于硝普钠,以及是否可以减少不良反应的发生。方法:将90例确诊为急性主动脉夹层合并高血压的急症患者,随机分成硝普钠治疗组(A组)30例,乌拉地尔100μg/min维持治疗组(B组)30例,乌拉地尔200μg/min维持治疗组(C组)30例,用药期间密切观察血压、心率变化,记录发生的不良反应。结果:用药后20min,3组治疗前后血压均明显下降,不同组间降压效果差异无统计学意义。用药后60min,C组心率明显低于其他2组,差异有统计学意义。B、C组不良反应率均明显低于A组,C组血压维持效果更稳定,血压波动小。结论:乌拉地尔与硝普钠均可有效降低主动脉夹层患者的高血压,但乌拉地尔的不良反应较少,到达目标血压后大剂量乌拉地尔维持降压效果更稳定。Objective：To compare the effect of urapidil and sodium nitroprusside on the treatment of aortic dissection hypertensive crisis,and to find a better way to reduce the hypertensive crisis more safely and reduce the adverese effects.Method：Ninety patients enrolled in our department were randomly divided into three groups,each urapidil and continued with 100μg/min and group C-patients were treated with an initial dose of 20 mg urapidil and continued with 200μg/min.Blood pressure and heart rate were carefully monitered and recorded.Result：Most of the patients reached the blood controll for hypertensive crisis with aortic dissection after 20 min of treatment,and there is no significant difference among groups.But the two urapidil treated groups have a significantly decrease in adverse effects compared with the sodium nitroprusside treated group,statistical evaluation showed P〈0.01.Futhermore,the high dose continured urapidil group is more steady in controlling the blood pressure at a goal state.At 60 min,the high dose continured urapidil group has a lower heart rate than the other groups,statistical evaluation showed（P〈0.01）.Conclusion：Both urapidil and sodium nitroprusside are effective in the treatment of aortic dissection hypertensive crisis,but urapidil has less side effects.And our recommended high dose of urapidil is more effective in sustain blood pressure at a steady goal state.

关 键 词：乌拉地尔 硝普钠 主动脉夹层 高血压危象 

分 类 号：R543.1[医药卫生—心血管疾病]