Meluzín J, Novák M
I. interní klinika fakultní nemocnice s poliklinikou U svaté Anny, Brno.
Vnitr Lek. 1992 Feb;38(2):122-8.
In 20 patients with stable angina II-III according to NYHA by means of ergometry the effect of short-term administration of dilthiazem (90 mg in three doses), placebo and isradipine (5 mg in three doses) in block of beta-receptors of the sympathetic nerve (metipranolol 3 x 10 mg/day) was compared. As compared with placebo, dilthiazem and isradipine retarded significantly the development of stenocardia, reduced the S-T depression in lead V5 and increased the total work output during ergometry. Based on the results of this and previous work (9) it may be stated that concurrent administration of metipranolol reduced the frequency of side-effects of isradipine and prevented the reflex rise of the heart rate following its short-terms administration. The authors conclude that starting treatment of stable angina with isradipine is safer and more effective in combination with metipranolol than when monotherapy is used. Dilthiazem must be administered with metipranolol carefully with regard to possible development of severe bradycardia and its suitable dose should be established by titration.
在20例根据纽约心脏协会（NYHA）分级为II-III级的稳定型心绞痛患者中，通过运动试验比较了短期服用地尔硫䓬（90毫克，分三次服用）、安慰剂和伊拉地平（5毫克，分三次服用）在交感神经β受体阻滞剂（美替洛尔3×10毫克/天）作用下的效果。与安慰剂相比，地尔硫䓬和伊拉地平显著延缓了心绞痛的发作，降低了V5导联的ST段压低，并增加了运动试验期间的总做功量。基于这项研究及之前研究（9）的结果，可以说同时服用美替洛尔可降低伊拉地平的副作用发生率，并防止其短期服用后心率的反射性升高。作者得出结论，与单药治疗相比，伊拉地平联合美替洛尔开始治疗稳定型心绞痛更安全、更有效。考虑到可能发生严重心动过缓，地尔硫䓬必须与美替洛尔谨慎联用，其合适剂量应通过滴定法确定。
