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患者男,63岁,因头昏,头痛,胸闷一周入院,有高血压病史20余年.体检:血压176/110,双肺(-),心律齐,心率90次/分,心尖部Ⅱ收缩期杂音,第一心音亢进,A_2>P_2,胸片:主动脉弓稍凸出,心脏呈主动脉型.心电图:窦性心律,电轴右偏-20°,逆钟向转位,右室肥厚劳损.实验室检查:血胆固醇,240mg%,三酸甘油脂130mg%,肌酐1mg%,尿素氮10mg%.入院后用常药降压片,心得安,双氢克尿塞,潘生丁,丹参等药物治疗血压不降.改用利血平肌注,每日二次,每次1mg,连用2天仍无效.改用10% GS 500ml加(艹卡)胺唑啉10mg静滴,滴速为25滴/分,用药前测血压为186/110,滴后约20分钟测血压为188/112,每隔10分钟测血压一次均在188～200/112～130之间,持续约一小时血压未下降且在递增中.用药期间患者突然出现烦燥不安,两上肢阵发性抽搐,意识呈朦胧状态,考虑系血压增高所致,即停用苄胺唑啉改用硝普钠10mg静滴.约40分钟后血压下降至170/100.上述症状消失.
Male, 63 years old, hospitalized for one week due to dizziness, headache and chest tightness, had a history of hypertension more than 20 years.Physical examination: blood pressure 176/110, both lungs (-), heart rate Qi, heart rate 90 beats / Noise, first heart sound hyperthyroidism, A_2> P_2, chest X-ray: Aortic arch slightly bulging, the heart was aortic type.Electrocardiogram: sinus rhythm, right axis deviation of -20 °, the clock reverse transposition, hypertrophy of the right ventricle Laboratory tests: blood cholesterol, 240mg%, triglyceride 130mg%, creatinine 1mg%, urea nitrogen 10mg% .After admission with the common antihypertensive tablets, propranolol, hydrochlorothiazide, dipyridamole, Instead of reserpine intramuscular injection, twice a day, each 1mg, 2 days continued to use ineffective use of 10% GS 500ml plus (艹 card) intravenous infusion of amine 10mg, dropping rate of 25 drops / min, Blood pressure was measured before treatment 186/110, about 20 minutes after the drop of blood pressure was measured 188/112, every 10 minutes to measure blood pressure were between 188 ~ 200/112 ~ 130 for about one hour blood pressure did not decline and increasing In patients with medication during the sudden emergence of irritability, paroxysmal upper limbs convulsions, the state of consciousness was hazy, consider the Department of blood pressure caused by the withdrawal of benzylazoline switch to sodium nitroprusside 10mg intravenous infusion of about 40 minutes later Blood pressure drops To 170/100. The above symptoms disappear.