Lupínek Z, Meluzín J, Lupínková Z
I. vnitrní katedra lékarské fakulty Univerzity J. E. Purkynĕ, Brno.
Cas Lek Cesk. 1990 Mar 2;129(9):278-82.
In 28 patients with chronic angina pectoris grade II-III (NYHA) the authors investigated the antianginous effect of captopril. All patients had a normal blood pressure and the diagnosis was confirmed by coronary angiography. The investigation was made in three sub-groups as a simple crossover experiment with a randomized onset. In 10 patients without dysfunction (group A) and eight with severe left ventricular dysfunction (group C) a short-term comparative study of captopril and placebo was made; 10 patients of group B took first for 7 days diltiazem, 3 X 60 mg, and then during subsequent weeks the action of diltiazem with placebo was compared and the action of diltiazem combined with captopril 3 X 25 mg per day. Captopril significantly reduced the blood pressure and Robinson's index at rest and during activity. It protracted significantly the time before the development of stenocardia in patients with left ventricular dysfunction and in the group treated with diltiazem where it reduced even further the incidence of stenocardias. ACE inhibitors may apparently enhance the effectiveness of diltiazem in normotensive patients with angina pectoris and it may be assumed that it will have an even more potent effect in concurrent hypertension or left ventricular dysfunction.
作者对28例II-III级（纽约心脏协会）慢性心绞痛患者研究了卡托普利的抗心绞痛作用。所有患者血压正常，诊断经冠状动脉造影证实。研究采用简单交叉试验，随机分组，分为三个亚组。对10例无功能障碍患者（A组）和8例严重左心室功能障碍患者（C组）进行了卡托普利与安慰剂的短期对比研究；B组10例患者先服用地尔硫䓬7天，3次/天，每次60mg，随后几周比较地尔硫䓬与安慰剂的作用，以及地尔硫䓬联合卡托普利（每天3次，每次25mg）的作用。卡托普利显著降低静息和活动时的血压及罗宾逊指数。它显著延长了左心室功能障碍患者和接受地尔硫䓬治疗组患者心绞痛发作前的时间，在该组中它甚至进一步降低了心绞痛的发生率。血管紧张素转换酶抑制剂显然可增强地尔硫䓬对血压正常的心绞痛患者的疗效，并且可以假定它在并发高血压或左心室功能障碍时会产生更强的作用。
