静脉滴注尼卡地平和硝普钠治疗高血压急症的比较

Intravenous drip nicardipine vs sodium nitroprusside in treating hypertension emergencies

目的：比较静脉滴注（静滴）尼卡地平和硝普钠治疗高血压急症病人的疗效及安全性。方法：高血压急症８３例随机分为２组。尼卡地平组４２例先静脉注射尼卡地平２ｍｇ，５ｍｉｎ后以２．５ｍｇ／ｈ静滴，继而每隔５ｍｉｎ以２．５ｍｇ递增至有效剂量（ＤＢＰ＜１３．３ｋＰａ），最大有效剂量不超过３０ｍｇ／ｈ，维持该剂量共２４ｈ。硝普钠组４１例开始给硝普钠０．５μｇ／（ｋｇ·ｍｉｎ），继而每隔５ｍｉｎ以０．５～１．５μｇ／（ｋｇ·ｍｉｎ）递增，达有效剂量即维持该剂量静滴２４ｈ［最大剂量＜１０μｇ／（ｋｇ·ｍｉｎ）］。结果：尼卡地平组降压起效时间（６．０±１．１ｍｉｎ）显著快于硝普钠组（１７．０±２．６ｍｉｎ），Ｐ＜０．０１；不良反应发生率（１４％）低于硝普钠组（４４％），Ｐ＜０．０５。结论：尼卡地平组起效快，且安全，优于硝普钠组。

AIM: To compare the clinical effects of iv drip nicardipine and sodium nitroprusside in treating hypertension emergencies. METHODS: Eighty_three hypertension emergencies were divided into 2 groups randomly. In nicardipine group 42 patients were given 2 mg iv and increased by 2.5 mg/h every 5 min until good result (DBP<13.3 kPa) and then maintained at the same dose intravenous infusion for 24 h(the maximum amount of dosage was 30 mg/h). In sodium nitroprusside group 41 patients were infused at 0.5μg/(kg·min) and increased by 0.5_1.5 μg/(kg·min) every 5 min until good result and maintained at the same dose for 24 h[the maximum amount of dosage was 10 μg/(kg·min)]. RESULTS: Both drugs reduced blood pressure, but iv nicardipine controlled hypertension more rapidly then sodium nitroprusside(iv nicardipine 6.0 ± 1.1 min, and sodium nitroprusside 17.0±2.6 min, P< 0.01). Adverse reactions were observed with both drugs [iv nicardipine 14%(6/42) and sodium nitroprusside 44%(18/41), P[WTBZ]<0.05]. CONCLUSION: Nicardipine is quicker effective and less adverse reaction than sodium nitroprusside in treating hypertension emergencies.