乌拉地尔与尼卡地平在颅内动脉瘤破裂急诊介入栓塞术中的疗效对比

Comparison of Nicardipine and Urapidil in transcatheter embolization therapy for intracranial aneurysm ruptured

目的观察比较乌拉地尔及尼卡地平在颅内动脉瘤破裂急诊介入栓塞术中控制性降压的效果以及安全性。方法选择2010年9月-2012年6月就诊于武警后勤学院附属医院的79例行急诊介入栓塞术的颅内动脉瘤破裂患者，随机分为乌拉地尔组（W组，n=39）和尼卡地平组（N组，n=40）；麻醉后根据血压高低W组先静注12．5～25mg乌拉地尔，然后以100—200μg／min持续泵入；N组先给予尼卡地平0．5～1．0mg静推，然后以10～40μg／min持续泵入，两组均根据血压情况调整药物剂量；记录治疗前后心率（HR）、平均动脉压（MAP）、呼吸末二氧化碳浓度（PETCO2）以及SB100蛋白的变化，记录用药过程中发生的不良反应。结果乌拉地尔组和尼卡地平组均能快速有效降低血压，两者没有发现显著性差异（P〉0．05）。治疗后尼卡地平组心率明显上升（P〈0．05），而乌拉地尔组心率有所下降，但较用药前心率变化无统计学差异（P〉0．05）。治疗后两组PETCO2及SB100蛋白较用药前均无显著性差异（P〉O．05）。此外，持续泵入尼卡地平易导致低血压的发生率增高，明显高于乌拉地尔组（P〈0．05）。结论乌拉地尔和尼卡地平均能有效降低血压，但乌拉地尔降压更加平稳、安全，不良反应较少。

Objective To observe the effect and adverse reactions in transcatheter embolization therapy of intracranial aneurysm ruptured, and compare Urapidil with nicardipine. Methods 79 patients with intracranial aneurysm ruptured admitted in between September, 2010 and June, 2012 were randomly divided into two groups, Urapidil ,group （n=39） and Nicardipine group （n=40）. The patients of Urapidil group received a 12.5mg Urapidil intravenous injection followed by the 100-200rig/rain intravenous transfusion, while Nicardipine group received a 0.5-ling Nicardipine intravenous injection, followed by the 10-40μg/min intravenous transfusion. The dosage was respectively adjusted based on the readings the patients＂ blood pressure in both groups. The patients＂ heart rate （HR）, mean arterial pressure （MAP）, end-tidal pressure of carbon dioxide （PETCO2）, SB100 protein, and adverse reaction were recorded and analyzed. Results It reflected no significant difference in lowering blood pressure between the two groups. Nicardipine group reflected a faster HR after the treatment with a significant difference （P〈0.05）. Urapidil group reflected a decreased HR after the treatment, yet carrying no significant difference comparing with it before the treatment （P〉0.05）. There was no significant difference in both PETCO2 and SBI00 protein between the two groups. Urapidil group had less adverse reactions than the Urapidil group, with a significant difference （P〈0.05）. Conclusion Both Urapidil and Nicardipine are considered being effective in reducing blood pressure rapidly. However, Urapidil demonstrated being more stable and safer, with mild reaction.