摘要
目的应用肱动脉血管超声及运动试验的方法对冠心病患者服硝酸酯类药后耐药性进行评价。方法根据给药的间期不同，采用随机、对照、双盲方法将６６例冠心病患者分为两组：Ａ组：硝酸异山梨醇每天４次（每６小时组）；Ｂ组：硝酸异山梨醇每天２次（每１２小时组），疗程均为１周。疗程前、后分别进行肱动脉血管超声观察血管内径对该药含服后反应及活动平板运动试验。结果疗程前Ａ组与Ｂ组硝酸异山梨醇１０ｍｇ含服后肱动脉内径均显著增加（３９０±０６６ｍｍｖｓ４４８±０８９ｍｍ和３８１±０５７ｍｍｖｓ４．３６±０７６ｍｍ），而疗程后Ｂ组肱动脉内径显著增加（４１０±０７９ｍｍｖｓ４．４５±０９１ｍｍ），Ａ组增加不明显（３９７±０８８ｍｍｖｓ４．０７±０９９ｍｍ）。两组服药后肱动脉内径比较差异有显著性。与疗程前比较，疗程后Ａ组运动诱发各导联ＳＴ段缺血型下移之和（ΣＳＴ）（８４５±２４１ｍｍｖｓ８．０８±３７２ｍｍ）及运动时间（７４５±２３３ｍｉｎｖｓ８．０１±２７８ｍｉｎ）无明显改善，而疗程后Ｂ组ΣＳＴ明显减少（９１５１±２５８ｍｍｖｓ５．３６±１６４ｍｍ）、运动时间显著性增加（７５９±２９２ｍｉｎｖ?
Objective The aim of this study was to evaluate nitrate tolerance in patients with coronary heart disease.Methods Sixty six patients with coronary heart disease were divided into two groups (group A and group B) in a random, controlled and bouble blind fashion, 10 20mg isosorbide nitrate was given every 6 hour in group A and every 12 hour in group B for one week. The diameter of brachial arteries was measured by vascular ultrasonography at baseline and after sublingual isosorbide nitrate 10mg. Treadmill exercise test was performed in all subjects at the begining and the end of therapeutic period.Results The diameter of brachial arteries was increased significantly after sublingual isosorbide nitrate in both groups at the begining of therapeutic period. At the end of therapeutic period, the diameter of brachial arterics was increased significantly in group B, but not in group A after sublingual isosorbide nitrate. Compared with those before therapeutic period, ΣST and treadmill walking time were improved significantly in group B, but not in group A at the end of therapeutic period. Conclusion Isosorbide nitrate given every 12 hours can avoid nitrate tolerance in the patients with coronary heart disease.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1998年第5期371-373,共3页
Chinese Journal of Cardiology
基金
湖南省科委资助
关键词
冠心病
运动试验
硝酸酯
耐药性
nitrate tolerance coronary heart disease vascular ultrasonography treadmill exercise
