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[冠心病患者中加洛帕米与硝苯地平、地尔硫䓬和替帕米的剂量反应关系]

[Dose-response relation of gallopamil in comparison with nifedipine, diltiazem and tiapamil in patients with coronary heart disease].

作者信息

Hopf R, Fleischer K, Forster A, Mohler C, Schulz P C, Kaltenbach M

机构信息

Abteilung für Kardiologie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt.

出版信息

Z Kardiol. 1989;78 Suppl 5:69-76.

PMID:2698566
Abstract

For effective treatment of coronary heart disease with calcium antagonists, knowledge of both the dose-response relationship of a remedy and equipotent dosage for comparison of different drugs is necessary. We performed controlled studies to evaluate the influence of single oral doses of calcium antagonists on ischemic ST-depression (calculated as the mean of all exercise and recovery minutes = mean ST-depression) in exercise ECGs of patients with proven CHD and stable angina pectoris. Ergometries were carried out under constant conditions, particularly with individually constant work load and duration. All calcium antagonists reduced ischemic ST-depression during ergometry dose-dependent when compared to placebo. Diltiazem: 90 mg: 6% (n.s.), 120 mg: 19% (n.s.) und 180 mg: 26% (p less than 0.025); gallopamil: 25 mg: 19% (n.s.), 50 mg: 34% (p less than 0.01) und 100 mg: 57% (p less than 0.0025); nifedipine-Cps.: 5 mg: 17%, 10 mg: 33% und 20 mg: 42%; nifedipine-Tbl.: 20 mg: 8% (p less than 0.05), 40 mg: 23% (p less than 0.057 und 60 mg: 31% (p less than 0.05); tiapamil: 300 mg: 30% (p less than 0.05) und 600 mg: 60% (p less than 0.01). As the result of our findings, comparable antiischemic effects can be expected with 120 mg diltiazem, 50 mg gallopamil, 20 mg nifedipin as capsule or 60 mg nifedipin as tablet and 600 mg tiapamil.

摘要

为了有效地使用钙拮抗剂治疗冠心病,了解药物的剂量反应关系以及用于比较不同药物的等效剂量是必要的。我们进行了对照研究,以评估单剂量口服钙拮抗剂对已确诊冠心病且稳定型心绞痛患者运动心电图中缺血性ST段压低(计算为所有运动和恢复分钟的平均值=平均ST段压低)的影响。运动试验在恒定条件下进行,特别是工作负荷和持续时间保持个体恒定。与安慰剂相比,所有钙拮抗剂在运动试验期间均能剂量依赖性地降低缺血性ST段压低。地尔硫䓬:90毫克:6%(无统计学意义),120毫克:19%(无统计学意义),180毫克:26%(P<0.025);加洛帕米:25毫克:19%(无统计学意义),50毫克:34%(P<0.01),100毫克:57%(P<0.0025);硝苯地平胶囊:5毫克:17%,10毫克:33%,20毫克:42%;硝苯地平片:20毫克:8%(P<0.05),40毫克:23%(P<0.057),60毫克:31%(P<0.05);替帕米:300毫克:30%(P<0.05),600毫克:60%(P<0.01)。根据我们的研究结果,预计120毫克地尔硫䓬、50毫克加洛帕米、20毫克胶囊剂型硝苯地平、60毫克片剂剂型硝苯地平和600毫克替帕米具有相当的抗缺血作用。

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