不同药物对高血压合并急性心力衰竭患者血压、心功能及生化指标的影响及其安全性

Influence of different drugs on blood pressure,cardiac function and biochemical indexes in patients with hypertension complicated acute heart failure and their safety

目的:比较不同药物对高血压(EH)合并急性心力衰竭(AHF)患者血压、心功能及生化指标的影响及其安全性。方法:本院的130例EH+AHF患者被随机均分为硝酸甘油组和乌拉地尔组,两组均接受常规治疗,治疗1周。观察比较两组治疗前后SBP、DBP、N末端脑钠肽前体(NT-proBNP)、LVEF、左室收缩末容积(LVESV)、左室收缩末内径(LVESd)、血肌酐(Scr)、总胆固醇(TC)、空腹血糖(FBG)水平及不良反应率。结果:与治疗前比较,两组治疗后SBP、DBP水平均显著降低,P均=0.001。与硝酸甘油组比较,乌拉地尔组治疗后NT-proBNP[(4308.26±437.17)ng/L比(2227.58±223.34)ng/L]、LVESV[(74.51±3.91)ml比(63.49±4.98)ml]、LVESd[(45.43±2.83)mm比(40.30±2.04)mm]、Scr[(82.25±5.68)μmol/L比(72.45±5.71)μmol/L]、TC[(3.26±0.54)mmol/L比(2.25±0.39)mmol/L]、FBG[(7.18±1.97)mmol/L比(6.24±1.64)mmol/L]水平均降低更显著,LVEF[(54.07±5.13)%比(59.53±4.74)%]升高更显著,P均<0.01。乌拉地尔组不良反应率显著低于硝酸甘油组(3.1%比13.9%),P=0.027。结论:乌拉地尔可显著改善高血压合并急性心力衰竭患者心功能且不良反应少,值得临床推广。

Objective:To compare influence of different drugs on blood pressure,cardiac function and biochemical indexes in patients with essential hypertension(EH)complicated acute heart failure(AHF)and their safety.Methods:A total of 130 EH+AHF patients of our hospital were randomly and equally divided into nitroglycerin group and urapidil group,both groups all received routine treatment,for one week.SBP,DBP,LVEF,left ventricular end-systolic volume(LVESV),left ventricular end-systolic dimension(LVESd),levels of N-terminal pro brain natriuretic peptide(NT-proBNP),serum creatinine(Scr),total cholesterol(TC),fasting blood glucose(FBG),and incidence rate of adverse reactions were observed and compared between two groups before and after treatment.Results:Compared with before treatment,there were significant reductions in SBP and DBP in two groups after treatment,P=0.001 all.Compared with nitroglycerin group after treatment,there were significant reductions in LVESV[(74.51±3.91)ml vs.(63.49±4.98)ml],LVESd[(45.43±2.83)mm vs.(40.30±2.04)mm],levels of NT-proBNP[(4308.26±437.17)ng/L vs.(2227.58±223.34)ng/L],Scr[(82.25±5.68)μmol/L vs.(72.45±5.71)μmol/L],TC[(3.26±0.54)mmol/L vs.(2.25±0.39)mmol/L]and FBG[(7.18±1.97)mmol/L vs.(6.24±1.64)mmol/L],and significant rise in LVEF[(54.07±5.13)%vs.(59.53±4.74)%]in urapidil group,P<0.01 all.Incidence rate of adverse reactions in urapidil group was significantly lower than that of nitroglycerin group(3.1%vs.13.9%),P=0.027.Conclusion:Urapidil can significantly improve cardiac function in patients with hypertension complicated acute heart failure with few adverse reactions,which is worth extending.