佩尔地平与硝酸甘油治疗高血压急症的临床对比研究

Randomized controlled trial of nicardipine vs.nitroglycerin in the treatment of hypertension emergency

目的 将佩尔地平和临床常用的硝酸甘油进行比较，探讨佩尔地平治疗高血压急症的疗效及其副反应。方法 共２４ 名收缩压高于２６７ ｋＰａ（２００ ｍｍＨｇ） 或舒张压高于１６０ ｋＰａ（１２０ ｍｍ Ｈｇ） 的高血压急症病人随机的接受佩尔地平或硝酸甘油静脉注射治疗，其中佩尔地平组１３ 例，硝酸甘油组１１ 例。两组均记录用药前及用药后５ 、１０ 、１５ 、３０ 、６０ 分钟时的心率和血压。以ＳＰＳＳ软件对用药前后的变化及两组间的变化值进行了比较。结果 与硝酸甘油相似，用药后５ 分钟起，佩尔地平即开始起效，用药后５ 、１０ 、１５ 、３０ 、６０ 分钟的血压较用药前均有明显的下降（ Ｐ 值均小于０００１） 。血压的变化值在两组间没有明显差异（ Ｐ 值均≥００５） 。但佩尔地平组的心率变化小于硝酸甘油组。佩尔地平组在６０ 分钟后的降压幅度为收缩压下降了２４ ％ ，舒张压下降了２５ ％ 。除１ 例出现面色潮红外，没有发现明显的副反应。结论 佩尔地平治疗高血压急症的降压效果与硝酸甘油相似，但心率变化较少。降压幅度符合ＪＮＣＶＩ的建议，是较理想的控制高血压急症的药物。

Objective To compare the efficacy and side effects of nicardipine and nitroglycerin in the treatment of hypertension emergency.Methods Totally 24 patients in hypertension emergency with systolic blood pressure higher than 26.7 kPa(200 mmHg) or diastolic blood pressure higher than 16 kPa(120 mmHg) were randomized to nicardipine and nitroglycerin group to receive intravenous infusion of either drug.Thirteen patients were in nicardipine group and 11 were in nitroglycerin group.Bothe the blood pressure and heart rate were recorded before and after 5,10,15,30,60 minutes of using the drug.Side effects were recorded accordingly.SPSS software was used for the comparison of change before and after treatment and also the comparison between tow groups.Results Similar to nitroglycerin,nicardipine has the blood pressure lowering effect as early as 5 minutes.The blood pressure after 5,10,15,30,60 minutes of using the drug were all significantly lower than that before the treatment (all the P values>0 001).The comparison of change of blood pressure between two groups was with no statistical significance(all<0 05).The percentage of blood pressure lowered 60 minutes after using nicrdipine was 24% and 25% for systolic and diastolic blood pressure respectively.No side effects were observed except one patient had flushing face in nicardipine group.Conclusions The efficacy of blood pressure lowering of nicardipine in the treatment of hypertension emergency is comparable to nitroglycerin,but the change of heart rate is smaller in nicardipine group.The percentage of blood pressure lowered by nicardipine is in accordance with what was suggested by JNC VI.So nicardipine is an idea drug in the treatment of hypertension emergency. [