2017 年第 12 期 第 12 卷

乌拉地尔联合尼莫地平治疗高血压并发脑出血对患者血肌酐和血钙水平及安全性的影响

作者：周峰马黎鲁国建傅国萍董芬

英文作者：

单位：312000浙江省绍兴第二医院神经内科

英文单位：

关键词：高血压；脑出血；尼莫地平

英文关键词：

• 摘要：

• 目的    探讨乌拉地尔联合尼莫地平治疗高血压并发脑出血对患者血肌酐和血钙水平及安全性的影响。方法    选取2014年6月至2016年6月期间浙江省绍兴第二医院收治的高血压合并脑出血患者144例，按照随机数字表法分为观察组和对照组，各72例。2组患者入院后均给予常规对症支持治疗，对照组给予盐酸乌拉地尔注射液静脉微泵注射治疗，观察组在对照组治疗的基础上联合口服尼莫地平片治疗，2组均连续治疗15 d。治疗前后检测患者血肌酐和血钙水平，行颅脑CT检查并计算脑血肿体积，采用美国国立卫生研究院卒中量表（NIHSS）评估神经功能损伤情况。记录治疗过程中的不良反应发生情况。对患者随访1年记录生存情况。结果    治疗前2组血肌酐、血钙、脑血肿体积和NIHSS评分差异无统计学意义(P＞0.05)。治疗后观察组血肌酐水平明显低于对照组［（65±7）μmol/L比（76±6）μmol/L］，血钙水平明显高于对照组［（2.55±0.25）mmol/L比（2.13±0.42）mmol/L］(P＜0.01)。治疗后观察组脑血肿体积和NIHSS评分明显低于对照组［（3.0±1.2）mm3比（5.1±1.4）mm3、（7.8±2.7）分比（9.6±2.1）分］(P＜0.01)。观察组和对照组不良反应发生率差异无统计学意义［12.5%（9/72）比18.1%（13/72）］(P＝0.61)。观察组1年生存率明显高于对照组［93.1%（67/72）比83.3%（60/72）］(P＝0.03)。Kaplan-Meier生存曲线分析显示观察组生存时间明显长于对照组（P＜0.001）。结论    乌拉地尔联合尼莫地平治疗高血压并发脑出血的临床效果明显，能明显提高血钙水平，降低血肌酐水平，减小脑血肿体积，并改善神经功能，且无明显不良反应。

• Effect of urapidil combined with nimodipine on serum creatinine, calcium and safety in hypertensive patients with cerebral hemorrhage

  Zhou Feng, Ma Li, Lu Guojian, Fu Guoping, Dong Fen

  Department of Neurology, Shaoxing Second Hospital, Zhejiang Province, Shaoxing 312000, China

  Corresponding author: Zhou Feng, Email: 3377151864@qq.com

  【Abstract】Objective    To investigate the effect of urapidil combined with nimodipine on serum creatinine, calcium and safety in hypertensive patients with cerebral hemorrhage. Methods    A total of 44 hypertensive patients with cerebral hemorrhage admitted from June 2014 to June 2016 in Shaoxing Second Hospital were randomly divided into observation group and control group, with 72 cases in each group. Both groups had routine symptomatic supportive treatments and intravenous injection of urapidil hydrochloride; the observation group took nimodipine additionally. After 15 d of treatment, serum levels of creatinine and calcium, volume of cerebral hematoma, score of the National Institutes of Health Stroke Scale（NIHSS） and adverse reactions were analyzed. Survival condition of patients was recorded in 1 year after treatment. Results    Serum levels of creatinine and calcium, volume of cerebral hematoma and the NIHSS score had no significant differences between groups before treatment(P＞0.05). After treatment, serum creatinine level was significantly lower, serum calcium level was significantly higher, cerebral hematoma volume and the NIHSS score were significantly less in observation group than those in control group［（65±7）μmol/L vs （76±6）μmol/L, （2.55±0.25）mmol/L vs （2.13±0.42）mmol/L, （3.0±1.2）mm3 vs （5.1±1.4）mm3, （7.8±2.7）points vs （9.6±2.1）points］（P＜0.01）. Incidence of adverse reactions had no significant difference between groups［12.5%（9/72） vs 18.1%（13/72）］（P＝0.61）. The 1 year survival rate in observation group was significantly higher than that in control group［93.1%（67/72） vs 83.3%（60/72）］（P＝0.03）. Kaplan-Meier survival curve showed that the survival time in observation group was significantly longer than that in control group（P＜0.001）. Conclusion    Urapidil combined with nimodipine treating hypertension complicated by cerebral hemorrhage can effectively increase serum calcium, reduce serum creatinine, diminish cerebral hematoma and improve neurologic function without significant adverse effects.

  【Key words】Hypertension;Cerebral hemorrhage;Nimodipine