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目的 :观察压宁定对硝普钠控制性降压效应及血浆内分泌激素的影响 ,探讨两药复合应用的可行性 ,为临床合理选用降压药提供参考。 方法 :择期全麻下颅脑手术病人 2 8例 ,ASA ～ 级 ,随机分为硝普钠 ( 组 ,14例 )和压宁定复合硝普钠 ( 组 ,14例 )两组。两组病人麻醉诱导和维持方法相同 ,平均动脉压均降低 30 %～40 % ,分别于降压前即刻、降压达预计值时、维持降压 30 min、停降压 10 min时观察降压诱导时间和降压药的用量 ,监测血流动力学指标 ,测定血浆肾素活性、血管紧张素 、醛固酮和心钠素的水平。 结果 : 组降压诱导时间和降压药用量明显低于 组 (P <0 .0 5 ) ; 组降压后心率 (HR)明显增快 ,降压期间出现快速耐药性 ,停降压后出现反跳性高血压 ,与 组比较有显著性差异 (P <0 .0 5 ) ;两组病人各时点所测肾素活性、血管紧张素 、醛固酮和心钠素水平与降压前相比有显著性差异 (P <0 .0 1) ,但组间比较无统计学意义。结论 :压宁定复合硝普钠控制性降压 ,在一定程度上优于单纯硝普钠降压。
OBJECTIVE: To observe the effect of ning ning ning on the controlled hypotensive effect of sodium nitroprusside and plasma endocrine hormones to explore the feasibility of the combination of two drugs for the clinical use of antihypertensive drugs to provide a reasonable reference. Methods: Twenty-eight patients undergoing craniotomy under general anesthesia were randomly divided into two groups: sodium nitroprusside (n = 14) and nifedipine (n = 14). The anesthesia induction and maintenance methods were the same in both groups. The mean arterial pressure was reduced by 30% -40%. The blood pressure was maintained at 30 min and depressurized at 10 min Induction time and the amount of antihypertensive drugs, hemodynamic indicators were measured, determination of plasma renin activity, angiotensin, aldosterone and atrial natriuretic peptide levels. Results: The time of antihypertensive treatment and the dosage of antihypertensive drugs were significantly lower than those of the control group (P <0.05). The HR of the antihypertensive group was significantly higher than that of the control group (P <0.05) (P <0.05). The renin activity, angiotensin, aldosterone, and atrial natriuretic peptide levels measured at each time point in both groups were significantly different from those before the antihypertensive treatment Compared with significant differences (P <0. 01), but the comparison between the groups was not statistically significant. CONCLUSION: Prescription of nifedipine and sodium nitroprusside is better than that of sodium nitroprusside in some extent.