目的 探讨乌拉地尔联合硝酸甘油治疗高血压急症的临床疗效。方法 选取2013年11月-2015年11月在延安市人民医院进行治疗的高血压急症患者60例，根据治疗方案的差别分为对照组和治疗组，每组各30例。对照组静脉滴注硝酸甘油注射液，10 mg加入到生理盐水250 mL中，滴速10~40 μg/min，且根据血压调整滴速。治疗组在对照组的基础上静脉微泵注射盐酸乌拉地尔注射液，50 mg溶于生理盐水50 mL中，滴速100~400 μg/min，根据血压调整速度。血压和临床表现稳定后，两组患者用药均逐渐减量。观察两组的临床疗效，同时比较两组患者治疗前后的血压和心率变化及不良反应发生情况。结果 治疗后，对照组和治疗组的总有效率分别为80.00%、95.00%，两组比较差异有统计学意义（P<0.05）。治疗5、30、60、120 min后，两组患者的SBP、DBP和HR均较同组治疗前显著改善，同组治疗前后差异具有统计学意义（P<0.05）；且治疗5、30 min后，治疗组患者的SBP、DBP和HR改善程度明显优于同期对照组，两组比较差异具有统计学意义（P<0.05）。结论 乌拉地尔联合硝酸甘油治疗高血压急症效果显著，安全性高、不良反应低，具有一定的临床推广应用价值。

Objective To observe the clinical effect of urapidil hydrochloride combined with nitroglycerin in treatment of hypertensive emergencies. Methods Patients (60 cases) with hypertensive emergencies in Yan'an People's Hospital from November 2013 to November 2015 were divided into control and treatment groups according to different treatments, and each group had 30 cases. The patients in the control group were iv administered with Nitroglycerin Injection, 10 mg added into normal saline 250 mL, the drop speed was 10-40 μg/min, which was adjusted according to the change of blood pressure. The patients in the treatment group were iv by micro-pump administered with Urapidil Hydrochloride Injection on the basis of the control group, 50 mg dissolved in normal saline 50 mL, the drop speed was 100-400 μg/min, which was adjusted according to the change of blood pressure. After blood pressure and clinical manifestation were stable, the dosage of drugs in two groups was gradually reduced. The clinical efficacy was evaluated, and the changes of blood pressure, heart rate, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 95.00%, respectively, and there were differences between two groups (P<0.05). After treatment for 5, 30, 60, and 120 min, SBP, DBP, and HR in two groups were significantly improved, and the difference was statistically significant in the same group (P<0.05). And after treatment for 5 and 30 min, the improvement of SBP, DBP, and HR in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Urapidil hydrochloride combined with nitroglycerin has a significant in treatment of hypertensive emergencies clinical effect with high security and low adverse reaction, which has a certain clinical application value.