首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (1): 67-72.doi: 10.3969/j.issn.1006-7795.2015.01.013

• 心血管疾病的诊断与治疗 • 上一篇    下一篇

乌拉地尔与硝酸甘油注射液在老年高血压合并糖尿病患者发作急性心力衰竭的临床有效性与安全性

杨伟1, 何婧瑜2, 王艳玲2, 谭静2, 范振兴2, 华琦2   

  1. 1. 首都医科大学宣武医院综合科, 北京 100053;
    2. 首都医科大学宣武医院心脏科, 北京 100053
  • 收稿日期:2014-12-10 出版日期:2015-02-21 发布日期:2015-01-31
  • 通讯作者: 华琦 E-mail:huaqi5371@medmail.com.cn
  • 基金资助:
    国家高技术研究发展计划(863计划)项目(2012BAI37B03).

Efficacy and safety of urapidil and nitroglycerin injection for treatment of hypertension and diabetes mellitus in elderly patients with acute heart failure

Yang Wei1, He Jingyu2, Wang Yanling2, Tan Jing2, Fan Zhenxing2, Hua Qi2   

  1. 1. Department of General Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
    2. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2014-12-10 Online:2015-02-21 Published:2015-01-31
  • Supported by:
    This study was supported by National High Technology Research and Development Program of China(2012BAI37B03).

摘要: 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.

关键词: 乌拉地尔, 高血压, 糖尿病, 老年患者, 心力衰竭

Abstract: 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.

Key words: urapidil, hypertension, diabetes mellitus, elderly patients, heart failure

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