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急诊病房中咪达唑仑与卡托普利治疗单纯性高血压急症患者的比较:双盲随机临床试验

Comparison of midazolam versus captopril in patients with uncomplicated hypertensive urgency in emergency ward: Double-blind randomized clinical trial.

作者信息

Khorsand Mohammad Reza, Enayatrad Mostafa, Yekesadat Seyed Meysam, Khodayar Maryam, Noyani Amir

机构信息

Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.

Clinical Research Development Unit, Bahar Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.

出版信息

ARYA Atheroscler. 2022 Jul;18(4):1-8. doi: 10.48305/arya.2022.26128.

Abstract

BACKGROUND

The urgency of uncomplicated blood pressure (BP) is known as a sudden rise in BP. The aim of this study was to evaluate the intravascular administration of midazolam as an emergency care to control BP against captopril in patients with uncomplicated hypertension (HTN).

METHODS

The present study was a double-blind parallel randomized clinical trial (RCT) study that was performed on patients with urgent HTN referred to Imam Hossein Hospital in Shahroud, Iran, in 2018. Patients with BP higher than 180/110 mmHg and with healthy vital organs were selected randomly and allocated into three groups of 43 participants. All patients' BP in both arms, and after a period of 10 minutes in the left arm, was checked and after administering the medication was checked again for 4 times of 15 minutes till 1 hour complete.

RESULTS

There were significant differences between systolic (P = 0.024), diastolic (P = 0.001), and mean BP (P = 0.009) in the midazolam group before and after treatment. The group of midazolam and captopril showed the greatest reduction of BP before, in the middle, and after carrying out the treatment methods. As such, systolic, diastolic, and mean BP showed 23.5% (P = 0.047), 17.4% (P = 0.021), and 20.5% (P = 0.031) reduction, respectively.

CONCLUSION

Midazolam can be used as an effective and low-risk drug for lowering BP. Midazolam also has a faster effect on lowering BP.

摘要

背景

单纯性血压(BP)急症是指血压突然升高。本研究的目的是评估咪达唑仑血管内给药作为一种紧急护理措施,用于控制单纯性高血压(HTN)患者的血压,并与卡托普利进行对比。

方法

本研究是一项双盲平行随机临床试验(RCT),于2018年对转诊至伊朗沙赫鲁德伊玛目侯赛因医院的急症高血压患者进行。选取血压高于180/110 mmHg且重要脏器健康的患者,随机分为三组,每组43名参与者。检查所有患者双臂的血压,在左臂测量10分钟后,给药后再检查4次,每次15分钟,直至1小时结束。

结果

咪达唑仑组治疗前后收缩压(P = 0.024)、舒张压(P = 0.001)和平均血压(P = 0.009)存在显著差异。咪达唑仑组和卡托普利组在实施治疗方法前、治疗过程中和治疗后血压下降幅度最大。收缩压、舒张压和平均血压分别下降了23.5%(P = 0.047)、17.4%(P = 0.021)和20.5%(P = 0.031)。

结论

咪达唑仑可作为一种有效且低风险的降压药物。咪达唑仑降压起效也更快。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b25b/9937673/a7769ab4b11f/ARYA-18-4-2379f1.jpg

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