乌拉地尔和尼卡地平治疗老年高血压急症的效果及老年高血压急症的诱因分析

目的探讨乌拉地尔和尼卡地平治疗老年高血压急症的效果和不良反应，并分析老年高血压急症的诱因。方法将老年高血压急症患者39例随机分为乌拉地尔组（A组）22例和尼卡地平组（B组）17例，分别给予乌拉地尔和尼卡地平降压，记录两组患者诱因、治疗前及治疗后5min、10min、15min、20min、25min、30min、60min、2h及离院时的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、症状缓解情况和不良反应。结果感染（占23．1％）、用药不当（占23．1％）、精神因素（占20．6％）是诱发老年高血压急症的常见诱因；两组患者治疗不同时间点SBP、DBP和MAP与治疗前比较，差异有统计学意义（P〈0．05）；两组患者治疗后5min SBP、DBP均明显下降，A组达显效水平，B组达有效水平．治疗10min后B组达显效水平，两组均在用药结束时显示最大降压效应。两组症状缓解时间、MAP下降25％所用时间比较，差异无统计学意义（P〉0．05），两组60min内达到目标血压的人数比较，差异无统计学意义（P〉0．05），治疗当中血压再次上升人数比较，差异无统计学意义（P〉0．05）。两组均未出现严重不良反应。结论乌拉地尔和尼卡地平降压效果均良好且较平稳，但乌拉地尔起效更快；两者对老年高血压急症症状的缓解效果相当：两者安全性均较好；感染、用药不当和精神因素是老年高血压急症的主要诱因。

Analysis on inducements of hypertensive emergencies in elderly patients and clinical efficacy between Urapidil and Nicardipine

Objective To investigate the efficacies and adverse reactions of Urapidil and Nicardipine on the elderly patients with hypertensive emergencies （HE）, and to analyze the inducements of HE. Methods 39 aged patients with hypertensive emergencies were randomly divided into group A and group B. As for group A, 22 patients were given with Urapidil. 17 patients in group B were given with Nicardipine. The situations of patients in the two groups were recorded before therapy and after therapy in 5 min, 10 min, 15 min, 20 min, 25 min, 30 min, 60 min, 2 h and before discharge, including SBP, DBP, MAP, symptems, and adverse effects. Results The common inducements of HE includ- ed the infection （23.1%）,＇ inappropriate use of medicine （23.1%）, and psychic factor （20.6%）. The values of SBP, DBP and MAP were significantly different between before therapy and after therapy （P 〈 0.05） in the two groups. The levels of SBP and DBP of patients in the group A were significantly reduced in 5 min, while those in group B were affectively andsignificantly reduced in 10 min after therapy respectively, and then were reduced gradually and reached the best therapy efficacy at the end. There were no significant differences in the symptomatic relief time, the duration time of MAP being reduced 25% （P 〉 0.05）, there was no significant difference in the number of patients whose BP reached the aim level within 60 min （P 〉 0.05）, there was no significant difference in the number of patients whose BP were in- creased again during therapy between the two groups （P 〉 0.05）. The adverse effects were light in the two groups. Conclusion Urapidil and Nicardipine have similar and satisfactory efficacy on therapy and symptoms relief of the aged patients with hypertensive emergencies, and decrease the BP steadily, but Urapidil acts more faster. Both drugs are safe. Infection, inappropriate medication and mental factors are the main inducements.