Abstract:

Objective　To observe the effect of sodium nitroprusside on the clinical signs and prognosis of hypertensive crisis patients. Methods　This was a randomized controlled trial. A total of 90 hypertensive crisis patients admitted to the First People's Hospital of Nanyang City from March 2020 to May 2022 were included. The enrolled patients were divided into an observation group (45 cases) and a control group (45 cases) by the random number table method. In the observation group, there were 25 males and 20 females, aged 48-72 (60.48±5.17) years. In the control group, there were 23 males and 22 females, aged 50-70 (61.32±5.21) years. The control group was treated with urapidil on the basis of conventional treatment, and the observation group was treated with sodium nitroprusside on the basis of conventional treatment until the blood pressure control reached the standard. The changes of basic signs and cardiac function before and after treatment, and the recovery time of clinical symptoms and medication safety after treatment were compared between the two groups. All patients were followed up for 1 year to compare the prognosis of the two groups. χ² test and t test were used. Results　Before administration (T0), there were no statistically significant differences in the blood pressure and cardiac function between the two groups (all P>0.05). After 10 min of administration (T1), the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the observation group were (185.33±20.46) mmHg (1 mmHg = 0.133 kPa) and (131.42±20.77) mmHg, which were lower than those in the control group [(197.45±20.18) mmHg and (145.33±20.42) mmHg], with statistically significant differences (both P<0.05); the left ventricular ejection fraction (LVEF) of the observation group was higher than that of the control group [(48.72±10.33)% vs. (42.14±10.36)%], but the left ventricular end-diastolic diameter (LVDD) was lower than that of the control group [(50.25±10.37) mm vs. (56.77±10.41) mm], with statistically significant differences (both P<0.05). After 30 min of administration (T2), there were no statistically significant differences in the blood pressure and cardiac function between the two groups (all P>0.05). Under different treatment schemes, the recovery time of physical signs of the observation group was (12.33±3.41) min, the improvement time of cardiac function was (20.24±5.12) min, and the auxiliary ventilation time was (3.44±0.27) h, which were shorter than those of the control group [(14.49±3.15) min, (23.19±5.41) min, and (4.18±1.25) h], with statistically significant differences (all P<0.05). Under different treatment regiments, the incidence of drug-related adverse reactions in the observation group was 8.89% (4/45), and the incidence of cardiovascular adverse events during follow-up was 11.11% (5/45), which were lower than those in the control group [22.22% (10/45) and 26.67% (12/45)], with statistically significant differences (both P<0.05). Conclusion　Sodium nitroprusside can rapidly improve the basic signs and cardiac function of hypertensive crisis patients and accelerate the patients' rehabilitation process, with drug safety, which can improve the patients' prognosis to a certain extent.

Key words:

Sodium nitroprusside, Hypertensive crisis, Basic physical signs, Cardiac function, Prognosis

摘要：

目的　观察硝普钠对高血压危象患者临床体征及预后情况的影响。方法　本文为随机对照试验，病例纳入南阳市第一人民医院2020年3月至2022年5月期间收治的90例高血压危象患者，采用随机数字表法对入组患者进行分组，分别列为观察组（45例）和对照组（45例）。观察组中男25例，女20例，年龄48～72（60.48±5.17）岁；对照组中男23例，女22例，年龄50～70（61.32±5.21）岁。对照组在常规治疗基础上应用乌拉地尔，观察组在常规治疗基础上应用硝普钠，至血压控制达标为止。比较两组患者治疗前后的基础体征及心功能变化情况，治疗后的临床症状恢复时间及用药安全性，对所有患者开展为期1年随访，比较两组预后情况。用χ²检验、t检验。结果　给药前（T0），两组患者的血压及心功能差异均无统计学意义（均P>0.05）。在不同治疗方案下，给药10 min后（T1），观察组的收缩压（SBP）为（185.33±20.46）mmHg（1 mmHg=0.133 kPa），舒张压（DBP）为（131.42±20.77）mmHg，均低于对照组［（197.45±20.18）mmHg、（145.33±20.42）mmHg］，差异均有统计学意义（均P<0.05）；观察组T1时的左心室射血分数（LVEF）高于对照组［（48.72±10.33）%比（42.14±10.36）%］，左心室舒张末期内径（LVDD）低于对照组［（50.25±10.37）mm比（56.77±10.41）mm］，差异均有统计学意义（均P<0.05）。给药30 min后（T2），两组患者的血压及心功能差异均无统计学意义（均P>0.05）。在不同治疗方案下，观察组的体征恢复时间为（12.33±3.41）min，心功能改善时间为（20.24±5.12）min，辅助通气时间为（3.44±0.27）h，均短于对照组［（14.49±3.15）min、（23.19±5.41）min、（4.18±1.25）h］，差异均有统计学意义（均P<0.05）。在不同治疗方案下，观察组的药物相关不良反应发生率为8.89%（4/45），随访期间的心血管不良事件发生率11.11%（5/45），均低于对照组［22.22%（10/45）、26.67%（12/45）］，差异均有统计学意义（均P<0.05）。结论　硝普钠能迅速改善高血压危象患者的基础体征及心功能，并加快患者康复进程，且此药用药安全性较高，可一定程度上改善患者预后。

关键词:

硝普钠, 高血压危象, 基础体征, 心功能, 预后