小剂量卡托普利联合硝酸甘油静滴治疗高血压急症的疗效观察

Efficacy of Small doses captopril combined nitroglycerin treated for hypertensive emergencies

目的:观察小剂量卡托普利联合硝酸甘油静滴治疗高血压急症的疗效。方法:将广东省怀集县人民医院急诊收治的高血压急症患者60例随机分为观察组与对照组,每组30例,对照组采用25mg卡托普利舌下含服联合硝酸甘油10ml葡萄糖溶液静脉滴注,观察组药物剂量为对照组的一半,比较治疗前及治疗后的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)水平及不良反应情况。结果:两组治疗10min、15min、30min及1h的SBP、DBP及MAP水平均显著低于治疗前,P<0.001;观察组治疗10min、治疗15min、治疗30mim及治疗1h的SBP、DBP及MAP水平均显著高于对照组,P<0.05;观察组治疗1h后的MAP平均降低幅度为22.1%,对照组为30.5%;观察组降压幅度在高血压急症指南推荐范围内(治疗1h内MAP平均降低幅度不超过25%);两组患者治疗1h内咳嗽、皮疹、心率加快及血压过低等并发症比较差异无统计学意义;观察组总并发症(16.7%vs 43.3%)显著低于对照组,P<0.05。结论:小剂量卡托普利联合硝酸甘油静滴治疗高血压急症可有效降低血压,降压更为平稳,总并发症相对较少,值得临床推广。

Objective to explore the efficacy of Small doses captopril combined nitroglycerin treated for hypertensive emergencies. Methods 60 patients with hypertensive emergencies from emergency department of huaiji coounty peopl＇s hospital were randomly divided into the observation group and the control group.each group contain 30 cases.the control group treated with 25 mg captopril combined 10ml nitroglycerin glucose solution intravenously.the observation treated with the same medical,the Dose for half of the control group.the ystolic blood pressure（SBP）, diastolic blood pressure（DBP）, mean arterial pressure（MAP） levels and adverse reactions were compared before and after treatment. Results the SBP, DBP, and MAP level at the first 10min, 15min, 30min and 1h were significantly lower than before treatment, P〈0.001.the SBP, DBP and MAP level at the first 10min, 15min, 30min and 1h in the observation group was significantly higher than that in the control group. P〈0.05. The average magnitude lower of MAP in the observation group was 22.1%.and that was 30.5% in the control group.the average magnitude lower of MAP in the observation group was in the hypertensive emergency guidelines recommend range.（1h MAP reduce the therapeutic margin of no more than 25%）.the Cough, rash, rapid heart rate and low blood pressure rate in the two groups were compared with no significant difference.the total complications（16.7%vs 43.3%）in the observation group was significantly lower than the control group P〈0.05. Conclusions Low-dose captopril combined nitroglycerin therapy can effectively lower blood pressure .the hypertensive emergency water products, and more stable blood pressure, total complications relatively less worthy applications. buck is more stable,the total complications is fewer. it is worth applications.