CAJ | 학술논문

目的：研究对比乌拉地尔与硝酸甘油在老年高血压合并糖尿病患者发生急性心力衰竭时的疗效。方法将82名老年高血压合并糖尿病并发急性心力衰竭患者，采用数字表法将患者分为硝酸甘油组及乌拉地尔治疗组。观察不同时段2组患者血压、心率的变化情况，反映心功能指标的N末端B型利钠肽原（N terminal B type natriuretic peptide，NT-proBNP）、射血分数等指标变化情况，观察血糖、血脂浓度及肝、肾功能的情况。结果乌拉地尔组对收缩压的控制及NT-proBNP的改善明显优于硝酸甘油组。乌拉地尔组在治疗第7天，射血分数较硝酸甘油组明显升高，左室舒张末期容积减小。对心率及糖脂代谢无不良影响。治疗过程中乌拉地尔无不良事件发生。结论乌拉地尔在平稳降压，通过减轻心脏后负荷，从而改善心功能。对糖耐量、血脂代谢无不良影响。药效安全、可靠，未出现耐药反应。
목적：연구대비오랍지이여초산감유재노년고혈압합병당뇨병환자발생급성심력쇠갈시적료효。방법장82명노년고혈압합병당뇨병병발급성심력쇠갈환자，채용수자표법장환자분위초산감유조급오랍지이치료조。관찰불동시단2조환자혈압、심솔적변화정황，반영심공능지표적N말단B형리납태원（N terminal B type natriuretic peptide，NT-proBNP）、사혈분수등지표변화정황，관찰혈당、혈지농도급간、신공능적정황。결과오랍지이조대수축압적공제급NT-proBNP적개선명현우우초산감유조。오랍지이조재치료제7천，사혈분수교초산감유조명현승고，좌실서장말기용적감소。대심솔급당지대사무불량영향。치료과정중오랍지이무불량사건발생。결론오랍지이재평은강압，통과감경심장후부하，종이개선심공능。대당내량、혈지대사무불량영향。약효안전、가고，미출현내약반응。
Objective To evaluate whether the alpha-1 adrenoceptor blocker,urapidil,provides additional therapeutic benefits compared to nitroglycerin in treatment of non valvular heart failure complicated with hypertension and diabetes mellitus (DM)in elderly patients.Methods Eighty-two elderly patients with non valvular heart failure complicated with hypertension and diabetes mellitus were randomized into two groups who received either urapidil or nitroglycerin,respectively.All patients were monitored for blood pressure (BP),heart rate (HR),and received tests for metabolic activity and cardiovascular function prior to and after treatment.Results Patients receiving urapidil had significantly lower systolic blood pressure (SBP)than their counterparts in nitroglycerin group.Moreover, patients in urapidil group showed lower N-terminal B type natriuretic peptide (NT-proBNP)levels compared to patients in nitroglycerin group.While both urapidil and nitroglycerin decreased fasting plasma glucose (FPG)levels,there was no significant difference in FPG levels between these two groups.Conclusion Urapidil demonstrated better efficacy than nitroglycerin on lowering and stabilizing SBP, attenuating cardiac afterload,and improving cardiac function.Urapidil is a therapeutic option for the elderly patients complicated with hypertension and DM.