持续静脉泵入两种药物治疗高血压合并急性左心力衰竭的疗效比较

Effect comparison of two drugs in the creatment of hypertension complicating acute left heart failure via continuous intravenous pumping

目的比较持续静脉泵入乌拉地尔与持续静脉泵入硝普钠治疗高血压合并急性左心力衰竭的疗效。方法选取2013年4月至2014年4月重庆市三峡中心医院收治的高血压合并急性左心力衰竭患者78例,随机分为对照组和观察组,每组各39例。2组患者在综合治疗的基础上,对照组给予持续静脉泵入硝普钠治疗,观察组给予持续静脉泵入乌拉地尔治疗。对2组患者的总有效率,术后1h的收缩压、舒张压、心率,不良反应的发生率进行观察和比较。结果 (1)观察组患者的总有效率明显高于对照组患者的总有效率,差异有统计学意义(P<0.05)。(2)治疗后2组患者的收缩压、舒张压及心率均较治疗前明显降低,差异有统计学意义(P<0.05);治疗后观察组患者的心率较对照组明显降低,差异有统计学意义(P<0.05);而观察组的收缩压和舒张压改善方面与对照组比较,差异无统计学意义(P>0.05)。(3)观察组患者不良反应的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论持续静脉泵入乌拉地尔在高血压合并急性左心力衰竭治疗中治疗效果优于持续静脉泵入硝普钠,是安全可行的办法,值得临床推广应用。

Objective To compare the effect of urapidil and sodium nitroprusside by continuous intravenous pumping in the treatment of hypertension complicating acute left heart failure .Methods Totally 78 patients suffering from hypertension complicating acute left ventricular dysfunction in our hospital from April 2013 to April 2014 were selected and randomly divided into the control group and the experimental group ,39 cases in each group .On the basis of the comprehensive treatment ,the control group was given sodium nitroprusside by continuous intravenous pum‐ping ,while the observation group was given urapidil by continuous intravenous pumping .The total effective rate ,sys‐tolic blood pressure ,diastolic blood pressure ,heart rate at postoperative 1 h and the incidence rate of adverse reactions were observed and compared between the two groups .Results （1） The total effective rate after treatment in the ob‐servation group was significantly higher than that in the control group ,the difference was statistically significant（P〈0 .05） .（2） After treatment ,the systolic blood pressure（SBP） ,diastolic blood pressure（DBP） and heart rate（HR） of the two groups were significantly decreased compared with before treatment ,the differences were statistically signifi‐cant（P〈 0 .05） ;The HR after treatment in the observation group was significantly decreased compared with the con‐trol group ,the difference was statistically significant（P 〈 0 .05） ,but the improvement of SBP and DBP after treat‐ment had no statistical differences between the two groups（P〉 0 .05） .（3） The incidence rate of adverse reactions in the observation group was significantly lower than that in the control group with statistical difference（ P〈0 .05） . Conclusion The effect of continuous intravenous pumping of urapidil is superior to that of continuous intravenous pumping of sodium nitroprusside in treating hypertension complicating acute left heart failure ,which is a feasible and safe method ,and deserves to be widely applied in clinic .