舌下含服硝苯地平和静脉注射乌拉地尔治疗急性术后高血压的疗效观察

Efficacy of sublingual nifedipine and intravenous urapidil for treatment of acute postoperative hypertension

目的比较舌下含服硝苯地平和静脉注射乌拉地尔治疗急性术后高血压的疗效和安全性。方法对215例肿瘤切除术后因急性高血压接受降压治疗的患者资料进行回顾分析(舌下含服硝苯地平165例,静脉注射乌拉地尔50例)。结果用药后硝苯地平组收缩压平均下降5.9%,舒张压平均下降5.2%,乌拉地尔组收缩压平均下降12.1%,舒张压平均下降8.6%,两组之间的收缩压降幅和舒张压降幅有显著差异(Ps<0.001,Pd=0.019)。乌拉地尔30 min的达标率明显优于硝苯地平组(68%vs 35.8%,Pr<0.001)。结论虽然硝苯地平和乌拉地尔这两种药物在急性术后高血压治疗中均无明显副作用,但舌下含服硝苯地平的治疗效果不如静脉注射乌拉地尔。静脉注射乌拉地尔比舌下含服硝苯地平更适合于急性术后高血压的治疗。

Objective To compare the clinical efficacy and safety of sublingual nifedipine and intravenous urapidil in the treatment of acute postoperative hypertension.Methods The clinical data of 215 patients with APH after tumorectomy were retrospectively analyzed,among whom 165 were treated with sublingual nifedipine and 50 with intravenously urapidil.Results Treatment with sublingual nifedipine caused a reduction of the systolic blood pressure by 5.9% and diastolic blood pressure by 5.2%.Urapidil treatment resulted in significantly greater reductions in the systolic and diastolic blood pressures（by 12.1% and 8.6%,respectively）（Ps0.001,Pd=0.019）.Urapidil treatment was associated with a significantly higher rate of adequate antihypertensive effect than nifedipine treatment（68% vs 35.8%,P0.001）.Conclusion Although both urapidil and nifedipine are associated with minimal adverse effects,intravenous urapidil shows better therapeutic effect than sublingual nifedipine and is more suitable for the treatment of APH.