乌拉地尔、尼卡地平治疗老年高血压急症的临床疗效及安全性比较

目的]比较乌拉地尔与尼卡地平治疗老年高血压急症的临床效果及安全性.方法]选择2015年1月至2016年10本院收治的60例老年高血压急症患者为研究对象,按照随机分组原则将其分为乌拉地尔组和尼卡地平组,每组各30例.乌拉地尔组静脉注射12.5 mg,再予以50~200 μg/min乌拉地尔持续静滴;尼卡地平组给予静脉注射尼卡地平1 mg后,再予以10~40 μg/min持续静滴.结合患者血压变化情况适当优化、调整药物剂量,观察两组患者用药前后心率(HR)、血压变化情况及不良反应.结果]乌拉地尔组总有效率为90.00%(27/30),尼卡地平组总有效率为93.33%(28/30),两组总有效率比较差异无统计学意义(P>0.05).两组患者治疗10 min、20 min、30 min、60 min、120 min时SBP均显著低于治疗前,两组患者治疗60 min、120 min时DBP、HR均显著低于治疗前,差异均具有统计学意义(P<0.05);乌拉地尔组治疗10 min、20 min、30 min、60 min、120 min时HR显著低于尼卡地平组,差异具有统计学意义(P<0.05).两组患者在治疗期间均出现不同程度的口干、面红、便秘等不良反应,乌拉地尔组不良反应发生率6.7%(2/30)显著低于尼卡地平组的20.0%(6/30),组间差异具统计学差异(χ2=18.063,P<0.05).结论]乌拉地尔或尼卡地平治疗老年高血压急症患者,其临床治疗效果均良好,但乌拉地尔不良反应发生率更低,具有较好的用药安全性.

Comparison of Efficacy and Safety of Urapidil and Nicardipine in Elderly Patients with Acute Hypertension

Objective]To compare the clinical efficacy and safety of urapidil and nicardipine in the treatment of elderly patients with essential hypertension.Methods]Sixty cases of elderly hypertensive patients admitted from January,2015 to October,2016 were selected as the study data.According to the principle of randomization,they were divided into urapidil group and nicardipine group,30 cases in each group.Urapidil group was given intravenous injection of 12.5 mg,then given 50~200 g/min g/min urapidil continuous intravenous infusion;nicardipine group was given intravenous injection of nicardipine 1 mg,then 10~40 Mu A,continuous intravenous drip.In combination with the changes of blood pressure in patients,the dose of drugs was optimized and adjusted.The heart rate (HR),blood pressure changes and adverse reactions were observed before and after medication in two groups.Results]The total effective rate of urapidil group was 90% (27/30),and the total effective rate was 93.33% (28/30) in the nicardipine group,but there was no significant difference between the two groups (P>0.05).10 min,20 min,30 min,60 min and 120 min SBP of two groups of patients were significantly lower than those before treatment;60 min,120 min DBP and HR of two groups were significantly lower than that before treatment,the differences were statistically significant (P<0.05);The HR of urapidil group was significantly lower than that of nicardipine group at 10 min,20 min,30 min,60 min and 120 min,with statistical difference (P<0.05).Two groups of patients had different degrees of adverse reactions such as dry mouth,constipation,flushing during treatment,occurrence of adverse reaction rate of 6.7% (2/30) of the urapidil group was significantly lower than that of the nicardipine group (6/30 20%),with statistically significant differences between the groups (χ2=18.063,P<0.05).Conclusion]Urapidil or nicardipine is effective in the treatment of elderly hypertensive emergencies,but the incidence of adverse events of urapidil is lower,and it has better drug safety.