依那普利拉与硝普钠对急性Stanford A型主动脉夹层患者术后血浆氨基末端脑钠肽前体浓度影响的比较

发布时间：2018-12-18 21:15

【摘要】：目的:观察依那普利拉与硝普钠对急性Stanford A型主动脉夹层患者的降压效果;比较二者对术后血浆氨基末端脑钠肽前体(NT-pro BNP)浓度的影响。方法:40例Stanford A型主动脉夹层患者术前随机分入依那普利拉组(n=20)和硝普钠组(n=20),分别给予依那普利拉和硝普钠降压治疗,随后接受孙氏手术。术后,患者继续使用依那普利拉或硝普钠2 d。记录两组开始降压治疗后达到目标血压的例数、所需时间、不良反应及并发症,并于给药前及术后24和72 h抽取静脉血,测定血浆NT-pro BNP浓度。结果:依那普利拉组血压达标时间[(12.6±5.2)min]较硝普钠组[(8.1±4.8)min]长,两者差异有统计学意义(P0.05)。两组所有患者血压均能达标。两组死亡率和低血压发生率无统计学差异。两组患者术前血浆NTpro BNP浓度即出现升高;术后24 h最高;术后72 h下降,但仍较术前高。依那普利拉组患者血浆NT-pro BNP浓度在术后24和72 h均较硝普钠组明显减少。结论:依那普利拉与硝普钠均能迅速有效地降低急性Stanford A型主动脉夹层患者血压,但依那普利拉可使术后血浆NT-pro BNP浓度下降,显示出其潜在的心肌保护作用。
[Abstract]:Aim: to observe the antihypertensive effect of enalapril and sodium nitroprusside on acute Stanford A aortic dissection, and to compare the effect of enalapril and nitroprusside on the plasma concentration of amino-terminal brain natriuretic peptide (NT-pro BNP) after operation. Methods: 40 patients with Stanford A aortic dissection were randomly divided into enalapril group (n = 20) and sodium nitroprusside group (n = 20) before operation. After operation, patients continued to use enalapril or sodium nitroprusside for 2 days. The number of patients who reached the target blood pressure, the time required, the adverse reactions and complications were recorded. Venous blood samples were taken before administration and 24 and 72 hours after operation to determine the plasma NT-pro BNP concentration. Results: the time of blood pressure in enalapril group [(12.6 卤5.2) min] was longer than that in sodium nitroprusside group [(8.1 卤4.8) min], the difference was statistically significant (P0.05). The blood pressure of all patients in both groups was up to standard. There was no significant difference in mortality and hypotension between the two groups. The plasma NTpro BNP concentration in both groups increased before operation, reached the highest at 24 h after operation, and decreased at 72 h after operation, but still higher than that before operation. Plasma NT-pro BNP concentration in enalapril group was significantly lower than that in sodium nitroprusside group at 24 and 72 hours postoperatively. Conclusion: both enalapril and sodium nitroprusside can rapidly and effectively reduce the blood pressure of patients with acute Stanford A aortic dissection, but enalapril can decrease the plasma NT-pro BNP concentration after operation, indicating its potential myocardial protection.
【作者单位】：华中科技大学同济医学院附属同济医院心脏大血管外科;
【分类号】：R96

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