尼卡地平和乌拉地尔治疗慢性肾功能衰竭高血压急症的比较  

Comparison of urapidil and nicardipine in the treatment of chronic renal failure patients with hypertensive emergencies

作　　者：吴蕊[1] 董自平[2] 王胜奇[3] 秦俭[3] 

机构地区：[1]首都医科大学宣武医院风湿免疫科,北京100053 [2]华北石油管理局总医院急诊科,河北任丘062552 [3]首都医科大学宣武医院急诊科,北京100053

出　　处：《药学实践杂志》2016年第3期267-270,共4页Journal of Pharmaceutical Practice

摘　　要：目的 比较尼卡地平和乌拉地尔治疗肾功能衰竭患者高血压急症的治疗效果和不良反应。方法 59例慢性肾功能衰竭高血压急症患者,将其随机分为尼卡地平组30例和乌拉地尔组29例：尼卡地平组先给予尼卡地平1 mg静推,随后以30～100μg/min微量泵持续泵入,然后根据血压情况调整药物剂量;乌拉地尔组先给予乌拉地尔12.5 mg静推,然后以150～500μg/min微量泵持续泵入,根据血压情况调整药物剂量。记录用药前后心率、血压情况及不良反应。结果 两组治疗后的血压均较治疗前有明显下降（P〈0.05）,其中尼卡地平组在用药后1 h内降低收缩压的效果比乌拉地尔组更好（P〈0.05）,但随着治疗时间的延长（≥2 h）,两组收缩压之间的差异逐渐缩小（P〉0.05）;而降低舒张压的效果两组之间的差异没有统计学意义（P〉0.05）。乌拉地尔组用药后出现明显的心率减慢（P〈0.05）,而尼卡地平组心率明显加快（P〈0.05）。两组不良反应率比较没有统计学意义（P〉0.05）。结论 尼卡地平和乌拉地尔对肾功能衰竭患者高血压急症均有良好的治疗效果,尼卡地平早期应用效果更佳。Objective To study the efficacies and adverse reactions of urapidil and nicardipine in the treatment of the chronic renal failure patients with hypertensive emergencies. Methods 59 chronic renal failure patients with hypertensive emer- gencies were randomly divided into nicardipine treatment group and urapidil treatment group. The patients in the nicardipine group were given a 1 mg nicardipine intravenous injection, and 30-100μg/min intravenous transfusion was given continuously. The patients in the urapidil group were given a 12.5 mg urapidil intravenous injection, and 150-500μg/min intravenous trans- fusion was given continuously. The dosage were changed according to the patients＇ blood pressure in both of the groups. The patients＇ blood pressure, heart rate and adverse reactions were recorded. Results The patients＇ blood pressure in both of the groups were significantly lower after treatment （P〈0.05）. The SBP in nicardipine treatment group was significant lower than SBP in urapidil treatment group in the first hour after treatment （P〈0.05）. There was no significant difference in SBP be- tween the two groups 2 hours after treatment （P〉0.05）. There was no significant difference in DBP between the two groups after treatment （P〉0.05）. In the nicardipine group, the heart rate rose after the treatment, the difference was statistically significant （P〈0.05）. While in the urapidil group, the heart rate went down after the treatment, and the difference was statis- tically significant （P〈0.05）. There was no significant difference in adverse reactions between the two groups （P〉0.05）. Conclusion Both of nicardipine and urapidil were effective in the treatment of chronic renal failure patients with emergency hy-pertensive. Nicardipine was more effective in reducing the SBP in the first stage of treatment.

关 键 词：尼卡地平 乌拉地尔 高血压急症 肾功能衰竭 

分 类 号：R972[医药卫生—药品]