硝酸甘油和尼卡地平治疗肾性高血压急症的疗效观察

Efficacies of nitroglycerin or nicardipine in therapy of renal hypertensive emergency

目的：观察微量泵静脉注射硝酸甘油和盐酸尼卡地平治疗肾性高血压急症的疗效和安全性。方法：将肾性高血压急症患者86例随机分为A、B两组,A组43例给予硝酸甘油50 mg配伍到40 m L生理盐水中,应用输液泵30~66.7μg/min静脉泵入治疗;B组43例给予盐酸尼卡地平10 mg配伍到40 m L生理盐水中,应用输液泵30~66.7μg/min静脉泵入治疗,记录治疗前及治疗后60 min收缩压、舒张压、心率变化及不良反应。结果：治疗后60 min时两组收缩压、舒张压、心率变化比较有统计学差异（P〈0.05）;治疗后60 min时与同组治疗前比较,收缩压、舒张压均下降（P〈0.01）,心率增快（P〈0.01）。两组不良反应均较少,主要为头痛及窦性心动过速。结论：微量泵静脉泵入硝酸甘油治疗肾性高血压急症疗效优于尼卡地平,未见严重不良反应,可以临床推广应用。

Objective： To observe efficacy and safety of nitroglycerin or nicardipine in therapy of renal hypertensive emergency by intravenous use via mi- cre-pump. Methods ： Eighty-six patients with renal hypertensive emergency were randomized into group A and B. Group A（ n = 43 ） received nitroglycerin in dose of 50 mg diluted in 40 mL saline through infusion with micro-pump at speed of 30 μg/min to 66.7 μg/min,while group B were given nieardipine in dose of 10 mg diluted in 40 mL saline by intravenous use with micro-pump at speed of 30 μg,/min to 66.7 μg/min. The changes of systolic blood pressure （ SBP ） , diastolic blood pressure （ DBP）, heart rate （HR） and adverse reactions were recorded before administration and 60 minutes after infusion. Results： The two groups were statistically different concerning the changes of SPB, DPB and HR at 60 minute after administration （ P 〈 0.05 ）, and the SBP and DBP were decreased, and HR was increased within the group by 60 minute after infusion （ P 〈 0. 01 ）. Adverse reactions were less in the two groups of pa- tients, and primarily associated with headaches and sinus tachycardia. Conclusion ： Nitroglycerin is superior to nicardipine in therapy of renal hypertensive emergency by intravenous infusion via micro-pump, and there is no adverse reaction observed, suggesting that this drug is worthy of wider clinical recom- mendation.