乌拉地尔、硝酸甘油用于高血压急症院前急救临床研究［摘要］目的观察乌拉地尔、硝酸甘油注射液对髙血压急症的临床疗效，并分析其对心率的影响。方法将80例高血压急症患者随机分为乌拉地尔组与硝酸甘油组各40例，乌拉地尔组给予乌拉地尔注射液25mg用0.9%氯化钠注射液20mL稀释，5min内静脉推注，随后用乌拉地尔50mg加入0.9%氯化钠注射液250mL中静脉滴注，初始速度为0.5mL/min(100ug/min)；硝酸甘油组给予硝酸甘油注射液5mg加入0.9%氯化钠注射液250mL中静脉滴注，初始速度为0.5mL/min(10ug/min)o比较两组给药前后血压、心率变化。结果乌拉地尔组、硝酸甘油组均可明显降低高血压急症患者血压，达到治疗目标，两组间疗效比较无明显差异，硝酸甘油组治疗后心率明显增快，不良反应较多。结论乌拉地尔作用迅速、降压平稳，不良反应轻微，是高血压急症院前急救的理想药物。［关键词］乌拉地尔；硝酸甘油；高血压急症；院前急救［中图分类号］R544.1［文献标识码］A［文章编号］1674-4721(2012)07(a)-0034-03ClinicalanalysisofUrapidilandNitroglycerinapplicationinprehospitalmedicalcareofhypertensiveemergenciesWANGDongWANGSuMOYongpanArmedPoliceFrontierCorpsHospitalofGuangdongProvince,Shenzhen518029,China[Abstract]ObjectiveToobservetheclinicaleffectofurapidilandnitroglycerininjectiononhypertensionemergenciesandanalyzeitsinfluenceonheartrate.MethodsEightycasesofhypertensionemergenciespatientswererandomlydividedintoUrapidilgroupandNitroglyc-eringroup,eachgroupof40cases・TheUrapidilgroupwastreatedwithintravenousinjectionof25mgUrapidilwithin5min,whichwasdilutedby20mLnormalsaline；Thenthegroupwasgivenintravenousdripof50mgUra-pidiltreatmentwithaninitialspeedof0.5mL/min(100ug/min),whichwasdilutedby250mLnormalsaline・TheNitroglyceringroupwasgivenintravenousdripof5mgNitroglycerininjectiontreatmentwithaninitialspeedof0.5mL/min(10Lig/min),whichwasdilutedby250mLofnormalsaline・Thechangesofbloodpressureandheartratesofthetwogroupsbeforeandafteradminis-trationwerecompared.ResultsThebloodpressureofhy-pertensionemergenciespatientsinbothUrapidilandNi-troglyceringroupswereallreducedandreachedthetar-getvalue,therewasnosignificantdifferencebetweenthetwogroups・TheheartratesoftheNitroglyceringroupincreasedobviously,whichhadmoreadversereac-tions・ConclusionUrapidilcanreducethebloodpressurerapidlyandstablywithlessadversereactions・Itisanidealdrugforprehospitalmedicalcareofhypertensiveemergencies・[Keywords]Urapidil；Nitroglycerin；Hypertensionemergencies；Prehospitalmedicalcare随着社会老龄化的发展和生活习惯、膳食结构的改变，我国高血压发病率呈现上升趋势，高血压急症越来越成为院前急救的常见危重症。本院急诊科近年来院前救治高血压急症患者80例，现报道如下：1资料与方法1.1一般资料选取2010年9月〜2012年3月本院120院前接诊的髙血压急症患者80例，所选患者全部符合中国高血压防治指南2005[1]和2010诊断标准[2]：全部血压明显升高(BP>180/120nunHg)并伴有进行性心、脑、肾等靶器官功能不全的表现。