摘要
目的 观察静脉注射地尔硫革(diltiazem合贝爽)治疗老年高血压危象患者的疗效。方法测定入院时A、B2组患者平均收缩压(MSBP)与平均舒张压(MDBP)。A组30例，2h内静脉注射合贝爽1～15μg／(min·kg)。B组31例，2h内静脉注射硝酸甘油5～100μg／min。测定2组用药前、2h后心电图，观察心率(HR)、ST．T、SBP、DBP、心肌耗氧量指数(SBP×HR)。结果治疗后A组与B组的MSBP，MDBP均与治疗前比较差异有非常显著性，P＜0．01。治疗后A组心肌耗氧指数、HR，与治疗前比较有非常显著下降，P＜0．01；与治疗前比较，B组心肌耗氧指数显著增加，P＜0．05，HR非常显著增加，P＜0．01。A组2例出现一过性Ⅰ度房室传导阻滞，调整输液速度后消失。未有严重低血压或心功能不全。B组有6例出现头昏、发胀、心慌，8例有明显头痛，其中3例不能耐受停止治疗。2组较治疗前ST-T改善，无统计学差异，无严重低血压和心功能不全。结论舍贝爽治疗高血压危象的疗效确切，起效较快，安全，不良反应少，适用于老年患者。
Objective To evaluate the effects of intravenous diltiazem for aged patients with hypertension crisis. Methods Intravenous diltiazem was given to group A(n=30, SBP 192.4±17.2mmHg and DBP 110.6±8.8 mmHg) 10-20 mg, and intravenous nitroglycerin was given to group B(n=31, SBP 189.7±16.9 mmHg and DBP 112.8± 7.4 mmHg) 10 mg within 2 hours. The blood pressure (BP) was observed after 5 min, doses recorded and regulated according to BP, ECG, HR, SBP, DBP, HR×SBP and tolerance dosage. Results After treatment with diltiazem and nitroglycerin the BP of all patients decreased significantly(P<0.01). More adverse events like headache(8 patients), dizziness, swelling, palpitation(6 patients) developed and 3 patients could not tolerate in group B. ST-T, in ECG improved in 2 groups but there was no statistical significance. None suffered from A-VB, severe low BP and heart failure. Conclusions The intravenous diltiazem is more effective and safer to treat aged patients with hypertension crisis.
出处
《实用老年医学》
CAS
2005年第1期35-36,共2页
Practical Geriatrics
