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目的:探讨不同负荷剂量的乌拉地尔针剂对急性缺血性卒中溶栓前血压控制及其对院内时间(DNT)延误的影响。方法:回顾性分析本院36例接受乌拉地尔降压后经静脉予组织型纤溶酶原激活剂(t-PA)行溶栓治疗的患者,根据负荷剂量分为A、B、C 3组:A组负荷剂量5 mg,B组负荷剂量12.5 mg,C组负荷剂量25 mg。分别比较3组收缩压(SBP)、舒张压(DBP)、DNT及3个月时MRS评分。结果:血压情况:与A组SBP(173.27±6.92)mm Hg、DBP(81.73±7.71)mm Hg比,B组SBP(165.80±7.76)mm Hg、DBP(80.93±6.95)mm Hg和C组SBP(154.80±10.69)mm Hg、DBP(73.60±5.13)mm Hg明显下降,差异有统计学意义(均P<0.01);DNT延误:与A组(89.00±25.76)min比,B组(76.73±20.20)min和C组(73.10±14.15)min均明显缩短(均P<0.01);3个月时MRS评分(0~1分比例):与A组(为45.5%)和C组(为50.0%)比,B组(为60.0%)百分比最高,差异有统计学意义(均P<0.01)。结论:乌拉地尔针剂首剂负荷12.5 mg可有效降压,使血压快速达标,且预后较好。
Objective: To investigate the effect of Urapidil injection at different loading doses on the control of blood pressure before thrombolysis and the delay in hospital time (DNT) in patients with acute ischemic stroke. Methods: A retrospective analysis of 36 patients treated with intravenous administration of tissue plasminogen activator (t-PA) thrombolytic therapy after intravenous administration of urapidil was retrospectively divided into A, B and C 3 Group A: 5 mg loading dose, 12.5 mg loading dose in group B and 25 mg loading dose in group C. The systolic blood pressure (SBP), diastolic blood pressure (DBP), DNT and MRS score at 3 months were compared between the three groups. Results: The blood pressure was significantly higher than SBP (173.27 ± 6.92) mm Hg, DBP (81.73 ± 7.71) mm Hg, SBP (165.80 ± 7.76) mm Hg, DBP (154.80 ± 10.69) mm Hg and DBP (73.60 ± 5.13) mm Hg in group B were significantly lower than those in group A (89.00 ± 25.76) min (P <0.01) (P <0.01). At 3 months, the MRS score (0 to 1) was significantly lower than that in group A (45.5%) and group C (50.0 %) Than those in group B (60.0%), the difference was statistically significant (all P <0.01). Conclusion: Urapidil injection at the first dose of 12.5 mg is effective in lowering blood pressure and achieving rapid blood pressure compliance with good prognosis.