目的 探讨乌拉地尔注射液治疗老年高血压合并急性心力衰竭患者的疗效。方法 选择老年高血压合并急性心力衰竭患者140例,随机分为乌拉地尔组70例,硝酸甘油组70例,分别于治疗前、治疗后1、2和3d观察收缩压、舒张压、心率的情况,并于治疗前和治疗后2d观察N末端B型钠尿肽前体(NT-proBNP)和LVEF的变化,评价2组药物不良反应。结果 乌拉地尔组治疗后1、2和3d收缩压、舒张压、心率较治疗前明显降低[(135.33±20.63)mm Hg,1mm Hg=0.133kPa,(127.13±16.67)mm Hg,(123.86±11.54)mm Hg vs(159.84±31.73)mm Hg,(73.00±12.85)mm Hg,(70.10±10.09)mm Hg,(67.86±7.03)mm Hg vs(83.84±17.32)mm Hg;(78.53±15.73)/min,(75.90±14.86)/min,(74.09±11.26)/min vs(85.99±19.66)/min;P〈0.05]。乌拉地尔组治疗后2dNT-proBNP水平较治疗前明显降低[(2858.81±4264.48)ng/L vs(4978.10±6772.53)ng/L,P〈0.05]。结论在老年高血压合并急性心力衰竭患者治疗中,乌拉地尔在降低血压、稳定心率、改善心功能方面疗效显著。
Objective To study the therapeutic effect of urapidil in elderly hypertension patients with acute heart failure (AHF). Methods One hundred and forty elderly hypertension patients with AHF were randomly divided into urapidil treatment group (n=70) and nitroglycerin treatment group (n:70). Their SBP,DBP and HR were recorded before and on days 1,2 and 3 after treatment,their serum NT-proBNP level and LVEF were measured before and on day 2 after treatment. Results The SBP and DBP were significantly lower and the HR was significantly slower in urapidil treatment group on days 1,2 and 3 after treatment than before treatment (135.33 ± 20.63 mm Hg, 127. 13± 16. 67 mm Hg, 123. 86± 11. 54 mm Hg vs 159. 84 ± 31. 73 mm Hg; 73.00±12.85 mm Hg,70.10+10. 09 mm Hg,67. 86±7. 03 mm Hg vs 83.84±17.32 mm Hg; 78.53±15.73/min,75.90±14.86/min,74.09±11.26/min vs 85.99±19.66/min,P〈0.05). The serum NT-proBNP level was significantly lower in urapidil treatment group on day 2 after treatment than before treatment (2858.81±4264.48 ng/L vs 4978.10±6772.53 ng/L,P〈0.05). Conclusion Urapidil can significantly reduce the blood pressure, stabilize the HR and improve the cardiac function in elderly hypertension patients with AHF.