Cowley A J, Stainer K, Fullwood L, Muller A F, Hampton J R
Department of Medicine, University Hospital, Queen's Medical Centre, Nottingham, U.K.
Int J Cardiol. 1990 Jul;28 Suppl 1:S45-52; discussion 52-3. doi: 10.1016/0167-5273(90)90150-4.
Ten patients with severe heart failure, symptomatic despite treatment with diuretics and captopril, completed a study of the effect of adding enoximone to their normal treatment. Enoximone or matching placebo was given for 4 weeks in randomized double-blind order following a single-blind placebo run-in period. Exercise capability was measured with two different treadmill protocols, a corridor walk test and by step-counting with body-worn pedometers. Cardiac output and limb blood flow were assessed non-invasively by measuring respiratory gases and by venous occlusion plethysmography. Measurements were made at rest and in response to treadmill exercise. The mean exercise tolerance measured using the modified Bruce treadmill protocol was increased from the placebo value (498 +/- 91 seconds) after both 2 weeks (573 +/- 94 seconds, P = 0.051) and 4 weeks of enoximone (572 +/- 100 seconds, P = 0.057). Enoximone increased exercise duration in fixed workload tests from the placebo value (252 +/- 75 seconds) after 2 weeks' treatment (431 +/- 98 seconds, P = 0.011) and after 4 weeks (381 +/- 85 seconds, (P = 0.01). The percentage improvement with the fixed workload test was greater than with the modified Bruce protocol at week 2 (P = 0.03) and at week 4 (P = 0.051). Enoximone increased the speed of walking 100 m at self-selected slow, normal and fast paces. It had little effect on customary activity of the patients. Enoximone increased cardiac output measured at rest and during submaximal exercise (P = 0.001). It also improved blood flow to the calf muscle at rest and after exercise (P = 0.01). Enoximone has a beneficial effect in chronic heart failure symptomatic despite treatment with diuretics and captopril. The magnitude of its effect, however, depends upon the technique used to assess it.
10名严重心力衰竭患者，尽管使用利尿剂和卡托普利治疗后仍有症状，他们完成了一项关于在常规治疗中加用依诺昔酮效果的研究。在单盲安慰剂导入期后，依诺昔酮或匹配的安慰剂以随机双盲顺序给药4周。运动能力通过两种不同的跑步机方案、走廊步行试验以及使用佩戴在身上的计步器计算步数来测量。通过测量呼吸气体和静脉闭塞体积描记法对心输出量和肢体血流量进行无创评估。测量在静息状态下以及对跑步机运动的反应中进行。使用改良布鲁斯跑步机方案测量的平均运动耐量在依诺昔酮治疗2周后（573±94秒，P = 0.051）和4周后（572±100秒，P = 0.057）均从安慰剂值（498±91秒）增加。在固定工作量测试中，依诺昔酮治疗2周后（431±98秒，P = 0.011）和4周后（381±85秒，P = 0.01），运动持续时间从安慰剂值（252±75秒）增加。在第2周（P = 0.03）和第4周（P = 0.051），固定工作量测试的改善百分比大于改良布鲁斯方案。依诺昔酮在自我选择的慢、正常和快步行速下增加了100米步行速度。它对患者的日常活动影响很小。依诺昔酮增加了静息状态下和次最大运动时的心输出量（P = 0.001）。它还改善了静息和运动后小腿肌肉的血流量（P = 0.01）。尽管使用利尿剂和卡托普利治疗后仍有症状，但依诺昔酮对慢性心力衰竭有有益作用。然而，其作用程度取决于用于评估它的技术。
