地尔硫对高血压急性脑卒中病人的降压治疗

Diltiazem in treating hypertension with acute stroke

目的 :观察地尔硫在高血压急性脑卒中病人中的降压作用。方法 :有急性脑卒中的高血压病人 6 5例 ,根据血压值不同 ,分为A组 31例 ,先采用地尔硫针剂 5 0mg溶于氯化钠注射液或 5 %葡萄糖注射液 2 5 0mL中 ,iv ,gtt ,2～ 4h滴完。 2 4h后 ,采用地尔硫缓释片剂 90mg ,po ,qd ,服用2wk。B组 34例 ,采用地尔硫缓释片剂 90mg ,po ,qd ,服用 2wk。结果 :A组和B组用药后d 14降压有效率分别为 90 %与 88% ,P >0 .0 5。A组病例静脉用药后 10 ,2 0 ,30 ,6 0 ,12 0min血压降压幅度与其前一观察时刻的血压值差别有显著意义 ,降压安全性达 90 %。 2组病例治疗后d 1,2 ,7,14的血压降压幅度与其前一观察值差别均有显著意义 ,治疗后d 7,14神经功能缺损评分和日常生活活动Barthel指数 ,与用药前比较差别均有显著意义。所有病例用药后不良反应轻微。结论 :地尔硫对高血压急性脑卒中病人的降压疗效确切、安全性高。

AIM: To study the therapeutic effect and safety of diltiazem in treating hypertension with acute stroke. METHODS: According to the blood pressure (BP) value, patients with hypertension in acute stroke (n=65) were assigned to two groups. Group A of 31 patients received diltiazem 50 mg in 0.9 % sodium chloride or 5 % glucose injection 250 mL iv, gtt, in 2-4 h, and 24 h later, received diltiazem SR 90 mg , po, qd for 2 wk. Group B of 34 patients received only diltiazem SR 90 mg, po, qd for 2 wk. RESULTS: The effective rate of group A was 90 %, similar to that of group B 88 %. With treatment of diltiazem iv, gtt of 10,20,30,60,and 120 min in group A, there were significant differences regarding the decrease of BP in comparing with the preceding corresponding BP. After the treatment of d 1, 2, 7 , 14 in two groups, there were also significant differences respectively for BP decrease. The safety rate of group A iv, gtt was 90 %. According to the Chinese Stroke Scale and the Barthel Score of two groups, there existed significant differences respectively after d 7 and d 14 of treatment. Adverse reactions were mild in all patients. CONCLUSION: Diltiazem is an effective and safe drug in treating hypertension with acute stroke.