乌拉地尔和尼卡地平治疗高血压急症的比较

目的:比较乌拉地尔和尼卡地平治疗高血压急症的疗效和不良反应。方法:78例高血压急症病人分为乌拉地尔组和尼卡地平组,每组39例,乌拉地尔组先予12.5~25mg,iv,后以4μg·kg-1·min-1,iv,gtt,根据血压情况调整滴速,最大维持量12μg·kg-1·min-1。尼卡地平组先予2mg,iv,然后以1μg·kg-1·min-1,iv,gtt,根据血压变化调整滴速,最大维持量6μg·kg-1·min-1。记录用药前后血压、心率等指标的变化。结果:乌拉地尔和尼卡地平组显效、有效和无效分别为36,3,0例和34,4,1例,2组疗效无显著差异(P>0.05),但治疗后乌拉地尔组心率明显下降,尼卡地平组心率明显上升,两者比较差异非常显著(P<0.01);尼卡地平组治疗后最大降压效果出现时间明显迟于乌拉地尔组(P<0.01);心绞痛发作和脑出血加重人数多于乌拉地尔组;不良反应率也高于乌拉地尔组。结论:2种药物治疗高血压急症均效果良好,但乌拉地尔起效更快、应用更安全、适用范围更广。

Urapidil vs nicardipine in treating hypertensive emergency

AIM: To compare the therapeutic effects and adverse reacti ons of u rapidil and nicardipine injection in treating hypertensive emergency. METHODS : Seventy-eight patients with hypertensive emergency were randomized into two g r oups:the urapidil group and the nicardipine group, including 39 ones in each. Th e former received urapidil 12.5-25 mg, iv first,and followed by 4 μg·kg  -1 ·min -1 intraven eously with the maximum maintaining does of 12 μg· kg -1 ·min -1 regulated by changes of blood pressure.The latter received nicardipine 2 mg, iv first , and then followed by 1 μg·kg -1 ·min -1 intraveneously with max imum maintainin g dose of 6 μg·kg -1 ·min -1 regulated according to the changes of b lood pressure. P arameters such as blood pressure and heart rate before and after the treatment w ere recorded. RESULTS: The clinical efficacies including excellent response , respo nse and no response recorded as individual number for urapidil vs nicardipin e gr oup were 36,3,0 vs 34,4,1 respectively with no significant difference betwee n th e two groups(P > 0.05). The heart rates in urapidil group decreased obvious ly a nd those of the nicardipine group increased significantly, showing conspicuous d ifference (P <0.01).The onset with maximum decrease of blood p ressure in nicardipine group was inferior to that of urapidil group(P<0.01).The inci denc e of angina, aggravation of cerebral bleeding and rate of adverse reaction were also high in nicardipine group than those of the urapidil group. CONCLUSION: Int ravenous urapidil and nicardipine are both effective in treating hypertensive em ergency ,but urapidil functions more rapidly, safer and apt to be recommended e xtensively.