| 乌拉地尔与1,6二磷酸果糖注射液对老年高血压合并急性左心力衰竭患者疗效与安全性研究 |
| 投稿时间：2017-03-21 修订日期：2017-04-21 点此下载全文 |
| 引用本文：马海英,铁虎光,韩荣胜.乌拉地尔与1,6二磷酸果糖注射液对老年高血压合并急性左心力衰竭患者疗效与安全性研究[J].医学研究杂志,2017,46(12):119-123 |
| DOI：
10.11969/j.issn.1673-548X.2017.12.030 |
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| 中文摘要:目的 探讨乌拉地尔与1，6二磷酸果糖注射液（fruc-tose-1，6-diphosphate，FDP）联合治疗老年高血压合并急性左心力衰竭的疗效与安全性。方法 选取于2014年3月~2015年5月在青海省第五人民医院心血管内科就诊的老年高血压合并急性心力衰竭62例，按数字表法随机分为乌拉地尔组30例，乌拉地尔与果糖联合治疗组（联合组）32例。两组患者均给予常规抗心力衰竭治疗（吸氧、强心、利尿、ACEI等）；乌拉地尔组静脉持续泵入乌拉地尔50~100μg/min，连续给药48h，后个体化调整给药时间；联合组在乌拉地尔组基础上，加予FDP注射液5.0g，10min内静脉滴注完毕，2次/天，共7天。比较分析两组患者临床疗效。观察记录两组患者治疗前与治疗后1、2、3、7天时各指标变化。记录两组患者在治疗期间的不良反应发生情况。结果 两组患者基线资料如性别、年龄等比较，差异无统计学意义（P>0.05）；联合组临床治疗总有效率显著高于乌拉地尔组（87.50% vs 73.33%，χ2=6.102，P=0.047）；两组患者在治疗后各时间点的收缩压、舒张压及心率均较治疗前逐渐降低（P<0.05），两组治疗后各时间点血压、心率比较差异无统计学意义（P>0.05）；与乌拉地尔组比较，联合组治疗后7天时射血分数（LVEF）、心脏指数（CI）显著升高（P<0.05），左心室收缩末期内径（LVESD）、左心室收缩末期容积（LVESV）显著减小（P<0.05），血浆N-末端脑利钠肽（NT-proBNP）水平显著降低（P<0.05）。两组均无反射性心率增快，对肝肾功能及糖脂代谢无不良影响，联合组不良事件少于乌拉地尔组，但差异无统计学意义（10.00% vs 3.13%，χ2=1.213，P=0.321）。结论 与单用乌拉地尔比较，乌拉地尔与果糖注射联合治疗老年高血压合并急性左心力衰竭时疗效更佳，不良反应更少，更有效的改善心脏功能。 |
| 中文关键词:乌拉地尔 1,6二磷酸果糖 老年高血压 急性左心力衰竭 |
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| Efficacy and Safety of Urapidil Combined with Fructose Injection in Hypertensive Elderly Patients with Acute Left Heart Failure |
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| Abstract:Objective To discuss the efficacy and safety of urapidil combined with fructose injection in hypertensive elderly patients with acute heart failure(AHF).Methods Sixty-two elderly patients with acute heart failure complicated with hypertension from cardiovascular medicine of the fifth people's hospital of qinghai province were randomized into urapidil group(n=30)and urapidil combined with fructose treatment group (combined group,n=32). Two groups of patients were given regular heart failure treatment (oxygen, strong heart, diuresis, ACEI, etc),patients in urapidil group were treated with urapidil 50-100μg/min, 48 h after continuous dosing, individualized adjust delivery time, dosing time adjustmented as individualized. On the basis of urapidil group, patients in combined group were treated with Fruc-tose-1,6-Diphosphate(FDP)injection of 5.0g, intravenous drip within 10 minutes,the duration was 7 days in two groups. The clinical efficacy was compared in two groups after treatment. Their parameters were compared before and on days 1,2,3 and 7 after treatment. The adverse reactions occur were recorded in patients of two groups during the treatment.Results There was no statistically significant difference in baseline data such as sex ratio, age, etc between the two groups(P>0.05). The total clinical efficacy rate in combined group was significantly higher than urapidil group(87.50% vs 73.33%,χ2=6.102,P=0.047). The systolic pressure, diastolic blood pressure and heart rate of each time after treatment were gradually lower than before treatment in the two groups patients. These was no statistical significance difference in blood pressure and heart rate between the two groups at each time point after treatment(P>0.05). Compared with urapidil group, the left entricular ejection fraction (LVEF) and cardiac index (CI) were rised significantly.The left ventricular end systolic diameter (LVESD) and left ventricular end systolic volume (LVESV) were significantly decreased. The plasma N-terminal brain natriuretic peptide (NT-proBNP) was significantly reduced (P<0.05) in combined treatment group patients after treatment 7 days. There was no reflectively heart rateaccelerating in combined treatment group. Urapidil combined with fructose showed no bad influence on blood glucose,cholesterol and triglyceride.And combined treatment groups patients had significantly less side effects than their counterparts in urapidil group, but had no obvious statistical significance difference (10.00% vs 3.13%, χ2=1.213, P=0.321).Conclusion Urapidil combined with fructose injection treatment hypertensive elderly patients with acute left heart failure demonstrated better efficacy and less side effects than urapidil alone on lowering and stabilizing systolic BP, improving cardiac function more significant. |
| keywords:Urapidil Fruc-tose-1,6-diphosphate Elderly hypertensive Acute left heart failure |
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