摘要
目的 比较静脉应用 5 单硝酸异山梨酯 (5 ISMN)和二硝酸异山梨酯 (ISDN)时达到抗心肌缺血作用所需起效时间的差异。方法 将 2 5例有心绞痛的冠心病患者随机分为ISDN组 (13例 )和 5 ISMN组 (12例 ) ,应用99mTc MIBI心肌断层显像和心电图分别观察用药前及用药后不同时间段 (3、15和 45min)心肌缺血改善情况。结果 ISDN组患者给药后 3min心肌99mTc MIBI稀疏缺损区即消失或明显缩小 11例 (84.6 %) ;而 5 ISMN组仅 2例 (15 .4%)有改善 ;用药后 15minISDN组的改善程度也明显优于 5 ISMN组。与给药前比较 ,ISDN组给药后 3和 15min99mTc MIBI心肌摄取比值和心电图有明显改善 ;而 5 ISMN组给药后 3min与给药前的差异无显著性 ,15min时虽有明显改善 ,但仍显著低于ISDN组 ;45min后两组心肌缺血改善情况的差异无显著性。结论 有心绞痛发作的冠心病患者静脉应用ISDN达到抗心肌缺血的作用所需的起效时间明显早于 5 ISMN ,可作为治疗急性抗心肌缺血的首选药物。
Objective To compare the taking-effect time of anti-myocardial ischemia between intravenous isosorbide dinitrate (ISDN) and isosorbide 5-mononitrate (5-ISMN) in patients with angina. Methods 25 patients with angina pectoris were enrolled and divided into ISDN (n=13) and 5-ISMN groups (n=12). After intravenous administration of the above drugs, myocardial ischemia in different time periods was observed by 99mTc-MIBI myocardial perfusion imaging and electrocardiogram (ECG). Results 99mTc-MIBI myocardial perfusion defect disappeared or significantly attenuated in 11 patients (84.6%) of ISDN group 3 min after intravenous administration, while only 2 patients were (15.4%) in 5-ISMN group. Moreover, the effect of ISDN was much better than that of 5-ISMN 15 min after administration. At 3 and 15 min after intravenous administration, the improvement of myocardial ischemic changes in ISDN group was more significant than that in 5-ISMN group as monitored by myocardial uptake ratio of 99mTc-MIBI and ECG. However, there were no significant differences between the two groups 45 min after administration. Conclusion The taking-effect time of intravenous ISDN is significantly earlier than that of 5-ISMN. Hence it would be the first choice for the acute myocardial ischemia patients with angina.
出处
《上海医学》
CAS
CSCD
北大核心
2003年第9期625-627,T001,共4页
Shanghai Medical Journal
