乌拉地尔和尼卡地平静脉用药对老年高血压急症患者儿茶酚胺的影响

目的:比较乌拉地尔和尼卡地平治疗老年高血压急症,对患者心率和儿茶酚胺的影响。方法:老年高血压急症患者39例,随机分为A组(乌拉地尔组)22例和B组(尼卡地平组)17例,分别给予乌拉地尔和尼卡地平降压。记录两组患者治疗前﹑治疗60min时﹑离院前的血压、心率水平,并检测患者血中去甲肾上腺素(NE)和肾上腺素(E)的浓度。结果:两组患者降压效果差异无统计学意义(P0.05)。两组治疗后同一时间点HR组间比较差异无统计学意义(P0.05)。A组治疗后与治疗前HR比较差异有统计学意义(P0.05)。B组治疗1h内与治疗前HR比较差异无统计学意义(P0.05),离院前差异有统计学意义(P0.05)。两组在治疗前﹑治疗60min时﹑离院前的血NE和E的组间比较及组内前后比较差异均无统计学意义(P0.05)。结论:以较规范的方法治疗老年高血压急症,乌拉地尔和尼卡地平均可取得满意效果。乌拉地尔在降压全程使心率显著下降,尼卡地平在降压的同时并不显著增加心率,降压一段时间后也可使心率下降。两者均未引起患者血浆儿茶酚胺升高。

Impact of Urapidil and Nicardipine on the level of catecholamine in elderly patients with hypertension emergencies

Objective：To investigate the efficacies of Urapidil and Nicardipine on the heart rate （HR） and the levels of catecholamine in old patients with hypertensive emergencies.Methods：39 patients （age ＞60y） 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 levels of SBP,DBP and HR in the two groups were recorded and the concentration of catecholamine was measured before therapy,after therapy in 1h and before discharge.Results：Both Urapidil and Nicardipine were efficacy in decreasing blood pressure（P ＞ 0.05）.There was no significant difference in HR between the two groups on the same time point（P ＞ 0.05）.In group A,HR on each time point after therapy was significantly lower than that before therapy （P ＜ 0.05）.In group B,HR had significant difference between before therapy and after 2h therapy （P ＜0.05）,while no significant difference was showed between before therapy and after therapy 1h.There was no significant difference in catecholamine on each time point between the two groups （P ＞ 0.05）.For each group,the catecholamine was similar before therapy,in 60min after therapy and before discharge （P ＞ 0.05）.Conclusion：Both Urapidil and Nicardipine were efficacy and safe for therapy of old patients with hypertensive emergencies.Both the two drugs did not increase the concentration of catecholamine in plasma during the whole process of the therapy of hypertensive emergencies.