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Am J Obstet Gynecol: 降低妊娠期急性高血压:静脉注射肼屈嗪vs口服硝苯地平

2017-12-28 吴星 环球医学

2017年12月,发表在《Am J Obstet Gynecol》上的一项双盲、随机、对照试验,考察了妊娠期使用静脉注射肼屈嗪和口服硝苯地平进行急性血压控制的有效性。

2017年12月,发表在《Am J Obstet Gynecol》上的一项双盲、随机、对照试验,考察了妊娠期使用静脉注射肼屈嗪和口服硝苯地平进行急性血压控制的有效性。

背景:在妊娠期急性高血压症期间,对于急性血压控制的最佳治疗选择缺乏高质量证据。

目的:研究人员旨在比较在妊娠期急性高血压患者中,使用静脉注射肼屈嗪和口服硝苯地平进行急性血压控制的有效性。

研究设计:在这项双盲随机对照试验中,把收缩压持续≥160mmHg或舒张压持续≥110mmHg的孕妇(妊娠≥24周)随机分配到静脉注射肼屈嗪和安慰剂片剂或口服硝苯地平和每20分钟静脉注射生理盐水的组中,目标血压为收缩压≤150mmHg和舒张压≤100mmHg的。其中,肼屈嗪的给药方案为5、10、10、10mg,4次给药,硝苯地平的给药方案为10mg片剂,4次给药。如果初始治疗失败了,则进行交叉治疗。首要结局为实现目标血压所必需的时间。次要结局为需要给药的次数、产妇和新生儿不良反应、围产期结局。

结果:2014年12月~2015年9月,入组了60例患者。两组(静脉注射肼屈嗪和口服硝苯地平)实现目标血压的中位时间均为40分钟(四分位区间分别为5和40分钟,P=0.809)。两组需要的中位给药次数为2(四分位范围分别为1和2次,P=0.625)。静脉注射肼屈嗪与呕吐不良事件的发生具有统计学意义(9/30 vs 2/30;P=0.042)。两组无严重不良产妇或围产期副反应发生。

结论:静脉注射肼屈嗪和口服硝苯地平在降低妊娠期急性高血压上等效。

原始出处:

Sharma C,et al. Hydralazine vs nifedipine for acute hypertensive emergency in pregnancy: a randomized controlled trial. Am J Obstet Gynecol. 2017 Dec;217(6):687.e1-687.e6. doi: 10.1016/j.ajog.2017.08.018. Epub 2017 Sep 1.

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    2018-03-02 fusion
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    2018-05-20 yhy100200
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