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[胺碘酮与缓释普萘洛尔的抗心绞痛作用。一项双盲随机研究]

[Anti-angina effect of amiodarone versus delayed-action propranolol. A double-blind randomized study].

作者信息

Varin J, Pelissier C, Legendre M, Delorme G, Dubourg O, Weiss P, Bourdarias J P

机构信息

Service de cardiologie, hôpital Cochin, Paris.

出版信息

Arch Mal Coeur Vaiss. 1990 Aug;83(9):1467-73.

PMID:2122869
Abstract

Long-acting Propranolol (160 mg/day) and Amiodarone (200 mg/day after impregnation) were compared in chronic stable angina pectoris. Forty-three patients with stable angina of effort were included in a randomised double blind trial (19 in the amiodarone and 24 in the propranolol group). The duration of the study was 8 weeks; the placebo phase (2 weeks) was followed by 6 weeks of active treatment. An exercise stress test was performed before and after the treatment period. The number of episodes of angina and the consumption of glyceryl trinitrate decreased significantly (p less than 0.001) in the same proportion with both drugs with respect to the placebo period. The time to the appearance of criteria of positivity of the exercise stress test increased from 6.82 +/- 0.50 mn to 8.35 +/- 0.50 mn with amiodarone, and from 7.15 +/- 0.47 mn to 9.50 +/- 0.52 with the propranolol preparation. This improvement was very significant compared with the placebo phase (p less than 0.001) but the difference between the two drugs was not statistically significant (p = 0.39). The other parameters which were studied (time to onset of angina, total duration of exercise, maximum heart rate, double product, maximum ST depression) changed in a parallel fashion significantly versus placebo. There were no differences between the two treatment groups with the exception of the resting heart rate which decreased more in patients on propranolol (80.94 +/- 3.92 to 62.47 +/- 1.97) than in patients on amiodarone (84.87 +/- 2.63 to 73.41 +/- 2.01; p less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

长效普萘洛尔(160毫克/天)与胺碘酮(负荷后200毫克/天)用于慢性稳定型心绞痛的疗效比较。43例劳力性稳定型心绞痛患者纳入一项随机双盲试验(胺碘酮组19例,普萘洛尔组24例)。研究持续8周;先有2周的安慰剂期,随后是6周的积极治疗期。在治疗期前后进行运动负荷试验。与安慰剂期相比,两种药物治疗后心绞痛发作次数和硝酸甘油消耗量均显著减少(p<0.001),且减少比例相同。运动负荷试验阳性标准出现时间,胺碘酮组从6.82±0.50分钟增至8.35±0.50分钟,普萘洛尔制剂组从7.15±0.47分钟增至9.50±0.52分钟。与安慰剂期相比,这种改善非常显著(p<0.001),但两种药物之间的差异无统计学意义(p = 0.39)。其他研究参数(心绞痛发作时间、总运动时间、最大心率、双乘积、最大ST段压低)与安慰剂相比均有显著的平行变化。除静息心率外,两个治疗组之间无差异,普萘洛尔组患者静息心率下降幅度大于胺碘酮组(从80.94±3.92降至62.47±1.97,而胺碘酮组从84.87±2.63降至73.41±2.01;p<0.0005)。(摘要截断于250字)

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