急性脑卒中血压控制：拉贝洛尔还是尼卡地平？

Blood Pressure Control in Acute Stroke: Labetalol or Nicardipine?

机构信息

Inpatient Pharmacy, Saint Joseph Mercy Hospital, 5301 E. Huron River Dr., Ann Arbor, MI 48106-0995, United States.

出版信息

J Stroke Cerebrovasc Dis. 2021 Sep;30(9):105959. doi: 10.1016/j.jstrokecerebrovasdis.2021.105959. Epub 2021 Jun 30.

DOI:10.1016/j.jstrokecerebrovasdis.2021.105959

PMID:34217067

Abstract

PURPOSE

To assess the safety and efficacy of continuous infusion (CIV)-labetalol compared to -nicardipine in controlling blood pressure (BP) in the acute stroke setting.

MATERIALS

Patients were eligible if they had a diagnosis of an acute stroke and were administered either CIV-labetalol or CIV-nicardipine. Study outcomes were assessed within the first 24 h of the antihypertensive infusion.

RESULTS

A total of 3,093 patients were included with 3,008 patients in the CIV-nicardipine group and 85 in the CIV-labetalol group. No significant difference was observed in percent time at goal BP between the nicardipine (82%) and labetalol (85%) groups (p = 0.351). There was also no difference in BP variability between nicardipine (37%) and labetalol (39%) groups (p = 0.433). Labetalol was found to have a shorter time to goal BP as compared to nicardipine (24 min vs. 40 min; p = 0.021). While CIV-nicardipine did have a higher incidence of tachycardia compared to labetalol (17% vs. 4%; p <0.001), the incidence of hypotension (13% vs. 15%; p = 0.620) and bradycardia (24% vs. 22%; p = 0.797) were similar.

CONCLUSIONS

These results indicate that CIV-labetalol and CIV-nicardipine are comparable in safety and efficacy in controlling BP for patients with acute stroke.

摘要

目的

评估持续输注（CIV）-拉贝洛尔与 CIV-尼卡地平在急性脑卒中患者中控制血压（BP）的安全性和有效性。

材料

如果患者被诊断为急性脑卒中且接受 CIV-拉贝洛尔或 CIV-尼卡地平治疗，则符合入组条件。降压输注后 24 小时内评估研究结局。

结果

共纳入 3093 例患者，其中 CIV-尼卡地平组 3008 例，CIV-拉贝洛尔组 85 例。尼卡地平（82%）和拉贝洛尔（85%）组之间目标血压的达标时间百分比无显著差异（p=0.351）。尼卡地平（37%）和拉贝洛尔（39%）组之间的血压变异性也无差异（p=0.433）。与尼卡地平相比，拉贝洛尔达到目标血压的时间更短（24 分钟 vs. 40 分钟；p=0.021）。虽然 CIV-尼卡地平的心动过速发生率高于拉贝洛尔（17% vs. 4%；p<0.001），但低血压（13% vs. 15%；p=0.620）和心动过缓（24% vs. 22%；p=0.797）的发生率相似。