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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.

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。

结论

这些结果表明,CIV-拉贝洛尔和 CIV-尼卡地平在急性脑卒中患者中控制血压的安全性和有效性相当。

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