Flynn J T, Mottes T A, Brophy P D, Kershaw D B, Smoyer W E, Bunchman T E
Division of Pediatric Nephrology, Department of Pediatrics and Communicable Diseases, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, USA.
J Pediatr. 2001 Jul;139(1):38-43. doi: 10.1067/mpd.2001.114030.
To examine the effect of intravenous nicardipine in the treatment of children with severe hypertension.
The medical records of 29 children (mean age 94 months) treated with intravenous nicardipine were retrospectively reviewed. The mean duration of severe hypertension before nicardipine use was 12.5 hours. Most (74%) patients were receiving other antihypertensive agents before nicardipine.
The initial nicardipine dose was 0.8 +/- 0.3 microg/kg/min (mean +/- SD). The mean effective dose was 1.8 +/- 1.0 microg/kg/min (range, 0.3 to 4.0). Blood pressure control was achieved within 2.7 +/- 2.1 hours after nicardipine was started. Nicardipine treatment produced a 16% reduction in systolic blood pressure, a 23% reduction in diastolic blood pressure, and a 7% increase in heart rate. Nicardipine was effective as a single agent on 26 (84%) of 31 occasions. Adverse effects included tachycardia, flushing, palpitations, and hypotension.
When administered in the intensive care unit setting with close patient monitoring, intravenous nicardipine effectively lowered blood pressure in children with severe hypertension. Larger prospective studies should be conducted to confirm these findings.
探讨静脉注射尼卡地平治疗儿童重度高血压的效果。
回顾性分析29例（平均年龄94个月）接受静脉注射尼卡地平治疗儿童的病历。使用尼卡地平前重度高血压的平均持续时间为12.5小时。大多数（74%）患者在使用尼卡地平前正在接受其他降压药物治疗。
尼卡地平初始剂量为0.8±0.3微克/千克/分钟（平均±标准差）。平均有效剂量为1.8±1.0微克/千克/分钟（范围为0.3至4.0）。开始使用尼卡地平后2.7±2.1小时内实现血压控制。尼卡地平治疗使收缩压降低16%，舒张压降低23%，心率增加7%。在31次治疗中有26次（84%）尼卡地平作为单一药物有效。不良反应包括心动过速、面部潮红、心悸和低血压。
在重症监护病房环境中进行密切患者监测时，静脉注射尼卡地平可有效降低儿童重度高血压患者的血压。应进行更大规模的前瞻性研究以证实这些发现。
