中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
9期
1051-1053
,共3页
张玉榕%贾荣波%张晓燕%范淑霞%季金枝
張玉榕%賈榮波%張曉燕%範淑霞%季金枝
장옥용%가영파%장효연%범숙하%계금지
主动脉夹层%高血压%氯丙嗪%硝普钠
主動脈夾層%高血壓%氯丙嗪%硝普鈉
주동맥협층%고혈압%록병진%초보납
Aortic dissection%Hypertension%Chlorderazin%Sodium nitroprusside
目的 探讨在硝普钠治疗主动脉夹层并高血压的基础上应用氯丙嗪的价值.方法 28例主动脉夹层伴高血压患者以随机数字法分为硝普钠组和氯丙嗪+硝普钠组各14例.2组均用硝普钠,以20μg/min开始持续静脉泵入,每隔5 min将硝普钠的用量增加5 μg/min.氯丙嗪+硝普钠组在此基础上加用氯丙嗪,始终以5μg/min静脉泵入.之后根据病情加用美托洛尔或其他降压药物口服,必要时再增加硝普钠用量,将血压维持在90～100/60～70 mm Hg(1 mm Hg=0.133 kPa),心率控制在65次/min左右.观察30 min内血压控制情况、美托洛尔日用量及累计止痛、止吐药物应用次数.结果 随着治疗时间的延长,收缩压、舒张压及心率在2组均呈下降趋势,其中收缩压在氯丙嗪+硝普钠组10 min及以后时间点,舒张压在15 min及以后时间点时下降幅度更大,组间比较,差异有统计学意义(P＜0.05).心率在氯丙嗪+硝普钠组15 min及以后时间点下降幅度更大,2组之间差异均有统计学意义(P＜0.05).在血压和心率均控制理想时氯丙嗪+硝普钠组的持续用药时间比硝普钠组明显缩短[分别为(74±10)、(56±12)h,P=0.030],此时硝普钠组美托洛尔日用量明显高于氯丙嗪+硝普钠组[分别为(65±20)、(46±19)mg,P=0.043].另外,硝普钠组累计止痛药物及止吐药物应用次数多于氯丙嗪+硝普钠组,差异有统计学意义[2组分别为(3.4±1.1)、(1.0±0.8)次,P=0.001;(1.4±0.8)、(0.4±0.3)次,P=0.005].结论 氯丙嗪是一种辅助硝普钠治疗主动脉夹层并高血压患者的理想药物.
目的 探討在硝普鈉治療主動脈夾層併高血壓的基礎上應用氯丙嗪的價值.方法 28例主動脈夾層伴高血壓患者以隨機數字法分為硝普鈉組和氯丙嗪+硝普鈉組各14例.2組均用硝普鈉,以20μg/min開始持續靜脈泵入,每隔5 min將硝普鈉的用量增加5 μg/min.氯丙嗪+硝普鈉組在此基礎上加用氯丙嗪,始終以5μg/min靜脈泵入.之後根據病情加用美託洛爾或其他降壓藥物口服,必要時再增加硝普鈉用量,將血壓維持在90～100/60～70 mm Hg(1 mm Hg=0.133 kPa),心率控製在65次/min左右.觀察30 min內血壓控製情況、美託洛爾日用量及纍計止痛、止吐藥物應用次數.結果 隨著治療時間的延長,收縮壓、舒張壓及心率在2組均呈下降趨勢,其中收縮壓在氯丙嗪+硝普鈉組10 min及以後時間點,舒張壓在15 min及以後時間點時下降幅度更大,組間比較,差異有統計學意義(P＜0.05).心率在氯丙嗪+硝普鈉組15 min及以後時間點下降幅度更大,2組之間差異均有統計學意義(P＜0.05).在血壓和心率均控製理想時氯丙嗪+硝普鈉組的持續用藥時間比硝普鈉組明顯縮短[分彆為(74±10)、(56±12)h,P=0.030],此時硝普鈉組美託洛爾日用量明顯高于氯丙嗪+硝普鈉組[分彆為(65±20)、(46±19)mg,P=0.043].另外,硝普鈉組纍計止痛藥物及止吐藥物應用次數多于氯丙嗪+硝普鈉組,差異有統計學意義[2組分彆為(3.4±1.1)、(1.0±0.8)次,P=0.001;(1.4±0.8)、(0.4±0.3)次,P=0.005].結論 氯丙嗪是一種輔助硝普鈉治療主動脈夾層併高血壓患者的理想藥物.
목적 탐토재초보납치료주동맥협층병고혈압적기출상응용록병진적개치.방법 28례주동맥협층반고혈압환자이수궤수자법분위초보납조화록병진+초보납조각14례.2조균용초보납,이20μg/min개시지속정맥빙입,매격5 min장초보납적용량증가5 μg/min.록병진+초보납조재차기출상가용록병진,시종이5μg/min정맥빙입.지후근거병정가용미탁락이혹기타강압약물구복,필요시재증가초보납용량,장혈압유지재90～100/60～70 mm Hg(1 mm Hg=0.133 kPa),심솔공제재65차/min좌우.관찰30 min내혈압공제정황、미탁락이일용량급루계지통、지토약물응용차수.결과 수착치료시간적연장,수축압、서장압급심솔재2조균정하강추세,기중수축압재록병진+초보납조10 min급이후시간점,서장압재15 min급이후시간점시하강폭도경대,조간비교,차이유통계학의의(P＜0.05).심솔재록병진+초보납조15 min급이후시간점하강폭도경대,2조지간차이균유통계학의의(P＜0.05).재혈압화심솔균공제이상시록병진+초보납조적지속용약시간비초보납조명현축단[분별위(74±10)、(56±12)h,P=0.030],차시초보납조미탁락이일용량명현고우록병진+초보납조[분별위(65±20)、(46±19)mg,P=0.043].령외,초보납조루계지통약물급지토약물응용차수다우록병진+초보납조,차이유통계학의의[2조분별위(3.4±1.1)、(1.0±0.8)차,P=0.001;(1.4±0.8)、(0.4±0.3)차,P=0.005].결론 록병진시일충보조초보납치료주동맥협층병고혈압환자적이상약물.
Objective To explore the efficacy of intravenous chlorderazin for patients with acute aortic dissection and hypertension. Methods Twenty-eight patients with aortic dissection-related hypertension were randomly assigned in sodium nitroprusside group and chlorderazin and sodium nitroprusside group. Hypertension controll within 30 minutes, betaxolol daily dose, and application number of times of analgesic and antiemetic between two groups were observed. Results During 30 minutes treatment, the systolic blood pressure, diostolic blood pressure and heart rate both decreased in sodium nitroprusside group and chlorderazin and sodium nitroprusside group. The degree of decline was more distinct in chlorderazin and sodium nitroprusside group after 15 minutes than that in sodium nitroprusside group. When blood pressure and heart rate were both under control, the continued drug use times were longer in sodium nitroprusside group than that in chlorderazin and sodium nitroprusside group[(74 ± 10)h vs (56 ±12) h, P = 0.030]. Betaxolol daily dose [(65 ± 20)mg vs (46 ± 19) mg, P = 0. 043] and application number of times of analgesic(3.4 ± 1.1 vs 1.0 ± 0.8, P = 0.001) and antiemetic (1.4 ± 0. 8 vs 0.4 ± 0.3, P = 0.005) were significantly more frequent in sodium nitroprusside group than those in chlorderazin and sodium nitroprusside group.Conclusion Intravenous Chlorderazin combined witn Sodium Nitroprusside is effective on treating aortic dissection-related hypertension.
