急性脑卒中的降压治疗

Antihypertensive therapies with acute stroke

目的 观察和比较地尔硫卓和赖诺普利在急性脑卒中患者中的降压作用。方法 有急性脑卒中的高血压病人 10 5例 ,根据血压值不同分为 3组 ,A组 33例 ,先给予地尔硫卓针剂 5 0mg溶于0 9%氯化钠注射液或 5 %葡萄糖注射液 2 5 0ml中静滴 ,2～ 4h滴完。 2 4h后 ,给予地尔硫卓缓释片剂90mg口服 ,每日一次 ,服用二周。B组 37例 ,给予地尔硫卓缓释片剂 90mg口服 ,每日一次 ,服用二周。C组 35例 ,给予赖诺普利片剂 10mg口服 ,每日一次 ,服用二周。结果 A组病例用药后第 14天降压有效率达 87 9% ,B组 86 5 % ,C组 85 7% ,3组病例有效率差别无显著意义。A组病例静脉用药后 10、 2 0、 30、 6 0、 12 0min血压降压幅度 (差值 )与其前一观察时刻的血压值差别有显著意义 ,3组病例用药后第 1天 ,第 2天 ,第 7天 ,第 14天的血压降压幅度 (差值 )与其前一观察值差别均有显著意义 ,B组与C组组间的相应降压幅度差别均无显著意义。A组病例静滴降压安全性达 87 9%。所有病例用药后不良反应轻微。结论 地尔硫卓和赖诺普利在急性脑卒中患者中的降压作用疗效确切、二者之间无显著差异、安全性高。

Objective To study the therapeutic effect and safety of dihiazem and lisinopril in treating hypertension with acute stroke. Methods According to the Blood Pressure （BP）value, patients with hypertension in acute stroke （ n = 105）were assigned to 3 groups. Group A of 33 patients received dihiazem 50rag in 0.9 % sodium chloride or 5%glucose 250 ml iv gtt in 2-4h, and 24h later, received dihiazem SR 90 mg qd for 2 wk. Group B of 37 patients received only dihiazem SR 90 mg qd for 2 wk. Group C of 35patients received only lisinopril 10 trig qd for 2 wk. Results The effective rate of group A was 87.9 %, similar to that of group B 86.5 %, and group C 85.7%. With treatment of dihiazem iv gtt of 10, 20, 30, 60 and 120 min in group A, there were significant differences regarding the decreased BP as compared with the preceding corresponding BP value. After the treatment of first, second, 7 th , 14 th day in 3 groups, there were significant differences respectively regarding the decreased BP as compared with the preceding corresponding BP value. Between the group B and C, there were no significant differences in the decreased BP during the corresponding periods. The safety rate of group A iv gtt was 87.9%. Adverse reactions were mild in all patients. Conclusion Dihiazem and lisinopril are two effective and safe drugs, there were no significant differences regarding their antihypertensive effect to patients with acute stroke.