摘要
高血压急症是一种以显著血压升高为特征的临床综合征，可导致靶器官损伤甚至危及生命，因此亟需安全有效的降压策略。本研究旨在探讨硝苯地平在高血压急症治疗中的紧急应用效果及其安全性。通过回顾性分析2018年至2023年间某三甲医院收治的300例高血压急症患者的临床资料，将患者分为硝苯地平舌下含服组和对照组（使用其他降压药物），对比两组患者的降压速度、血压控制达标率及不良反应发生情况。结果显示，硝苯地平组在用药后15分钟内平均动脉压下降幅度显著高于对照组，且血压控制达标率更高，差异具有统计学意义（P0.05）。同时，硝苯地平组的反射性心动过速发生率较低，未观察到严重不良反应。研究表明，硝苯地平舌下含服作为一种快速起效的降压方式，在高血压急症中具有良好的疗效与安全性，尤其适用于需要迅速降压的紧急情况。该研究为高血压急症的临床治疗提供了新的循证依据，并强调了个体化用药的重要性。关键词：高血压急症；硝苯地平；舌下含服；降压速度；安全性
Urgent Application of Nifedipine in the Treatment of Hypertensive Emergencies
Abstract
Hypertensive emergencies are clinical syndromes characterized by marked elevations in blood pressure, which can lead to target organ damage and even life-threatening conditions, thus necessitating safe and effective antihypertensive strategies. This study aimed to evaluate the efficacy and safety of nifedipine in the emergency treatment of hypertensive emergencies. A retrospective analysis was conducted on the clinical data of 300 patients with hypertensive emergencies treated at a tertiary hospital between 2018 and 2023. Patients were divided into two groups: those receiving sublingual nifedipine and a control group treated with other antihypertensive medications. The comparison focused on the rate of blood pressure reduction, the proportion of patients achieving blood pressure control targets, and the incidence of adverse reactions. The results showed that the decrease in mean arterial pressure within 15 minutes after medication was significantly greater in the nifedipine group than in the control group, with a higher rate of achieving blood pressure control targets, and the differences were statistically significant (P0.05). Additionally, the incidence of reflex tachycardia was lower in the nifedipine group, and no severe adverse reactions were observed. This study demonstrated that sublingual nifedipine, as a rapidly acting antihypertensive method, exhibits good efficacy and safety in the management of hypertensive emergencies, particularly in situations requiring immediate blood pressure reduction. The findings provide new evidence-based support for the clinical treatment of hypertensive emergencies and highlight the importance of individualized pharmacotherapy.
Keywords: Hypertensive Emergency; Nifedipine; Sublingual Administration; Blood Pressure Reduction Speed; Safety
目录
摘要 I
Abstract II
引言 1
1 硝苯地平的药理特性与作用机制 1
1.1 硝苯地平的药物分类与特点 1
1.2 钙通道阻滞剂的作用原理 2
1.3 硝苯地平在心血管系统中的作用 2
2 高血压急症的临床特征与治疗需求 3
2.1 高血压急症的定义与分类 3
2.2 高血压急症的病理生理机制 3
2.3 紧急降压治疗的目标与原则 3
3 硝苯地平在高血压急症中的应用现状 4
3.1 硝苯地平片剂的紧急使用方法 4
3.2 硝苯地平与其他降压药物的比较 4
3.3 临床研究中的疗效与安全性分析 5
4 硝苯地平应用中的问题与优化策略 5
4.1 使用硝苯地平的潜在风险与副作用 5
4.2 不同患者群体中的个体化用药策略 6
4.3 提高硝苯地平治疗效果的综合措施 6
结论 7
参考文献 8
致谢 9
