RESUMO
Objective To discuss the efficacy and safety of urapidil combined with fructose injection in hypertensive elderly patients with acute heart failure(AHF).Methods Sixty-two elderly patients with acute heart failure complicated with hypertension from cardiovascular medicine of the fifth people's hospital of qinghai province were randomized into urapidil group (n =30)and urapidil combined with fructose treatment group (combined group,n =32).Two groups of patients were given regular heart failure treatment (oxygen,strong heart,diuresis,ACEI,etc),patients in urapidil group were treated with urapidil 50-100μg/min,48 h after continuous dosing,individualized adjust delivery time,dosing time adjustmented as individualized.On the basis of urapidil group,patients in combined group were treated with Fruc-tose-1,6-Diphosphate (FDP) injection of 5.0g,intravenous drip within 10 minutes,the duration was 7 days in two groups.The clinical efficacy was compared in two groups after treatment.Their parameters were compared before and on days 1,2,3 and 7 after treatment.The adverse reactions occur were recorded in patients of two groups during the treatment.Results There was no statistically significant difference in baseline data such as sex ratio,age,etc between the two groups (P ＞ 0.05).The total clinical efficacy rate in combined group was significantly higher than urapidil group(87.50％ vs 73.33％,x2 =6.102,P =0.047).The systolic pressure,diastolic blood pressure and heart rate of each time after treatment were gradually lower than before treatment in the two groups patients.These was no statistical significance difference in blood pressure and heart rate between the two groups at each time point after treatment (P ＞ 0.05).Compared with urapidil group,the left entricular ejection fraction (LVEF) and cardiac index (CI) were rised significantly.The left ventricular end systolic diameter (LVESD) and left ventricular end systolic volume (LVESV) were significantly decreased.The plasma N-terminal brain natriuretic peptide (NT-proBNP) was significantly reduced (P ＜ 0.05) in combined treatment group patients after treatment 7 days.There was no reflectively heart rateaccelerating in combined treatment group.Urapidil combined with fructose showed no bad influence on blood glucose,cholesterol and triglyceride.And combined treatment groups patients had significantly less side effects than their counterparts in urapidil group,but had no obvious statistical significance difference (10.00％ vs 3.13％,x2 =1.213,P =0.321).Conclusion Urapidil combined with fructose injection treatment hypertensive elderly patients with acute left heart failure demonstrated better efficacy and less side effects than urapidil alone on lowering and stabilizing systolic BP,improving cardiac function more significant.