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[选择性与非选择性β受体阻滞剂对缺血性ST段、肺功能及应激诱导血糖降低的影响比较]

[Comparison of the effect of a selective and a nonselective beta receptor blocker on the ischemic ST segment, lung function and stress-induced decrease in blood glucose].

作者信息

Brügmann U, Blasini R

出版信息

Herz. 1986 Feb;11(1):55-61.

PMID:2870014
Abstract

This study was designed to compare the antihypertensive and anti-ischemic effects of the newly developed cardioselective beta-blocking agent, betaxolol, with the non-selective agent, nadolol, both of which have hydrophilic long acting properties, over a period of 48 hours. Additionally, the study was intended to determine whether betaxolol exerts a lesser influence on pulmonary function and whether beta-1- and beta-2-adrenergic blocking agents also induce a decrease in blood glucose levels during standard bicycle ergometry for three to nine minutes, similar to that reported in association with exercise of longer duration and, if so, whether this effect can be circumvented by the use of a selective agent. Ten patients with angiographically documented CAD, stable exercise angina pectoris and reproducible ST-segment depression of at least 1 mm received on day 1, in a single blind fashion, one tablet of placebo, on day 2 and day 7, in a double-blind, randomized and cross-over fashion, 20 mg betaxolol or 80 mg nadolol, respectively. Bicycle ergometry was performed before, four, 24 and 48 hours after drug with fixed work loads, blood glucose determination before and after ergometry four hours after drug and airway resistance and maximal ventilatory capacity studies were carried out five hours after drug administration. As compared with placebo, betaxolol and nadolol led to reductions of ST-segment depression of 65% (p less than 0.01) and 74% (p less than 0.005) at four hours, of 53% (p less than 0.025) and 56% (p less than 0.01) at 24 hours and 41% (p less than 0.05) and 44% (p less than 0.05) at 48 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究旨在比较新开发的心脏选择性β受体阻滞剂倍他洛尔与非选择性药物纳多洛尔的降压和抗缺血作用,这两种药物均具有亲水性长效特性,观察期为48小时。此外,该研究还旨在确定倍他洛尔对肺功能的影响是否较小,以及β1和β2肾上腺素能阻滞剂在标准自行车测力计运动三至九分钟期间是否也会导致血糖水平下降,这与较长时间运动时的情况类似;如果是这样,使用选择性药物是否可以避免这种影响。10例经血管造影证实患有冠心病、稳定型运动性心绞痛且可重复性ST段压低至少1mm的患者,在第1天以单盲方式服用1片安慰剂,在第2天和第7天以双盲、随机和交叉方式分别服用20mg倍他洛尔或80mg纳多洛尔。在给药前、给药后4小时、24小时和48小时进行固定工作量的自行车测力计运动,给药后4小时运动前后测定血糖,并在给药后5小时进行气道阻力和最大通气量研究。与安慰剂相比,倍他洛尔和纳多洛尔在4小时时使ST段压低分别降低65%(p<0.01)和74%(p<0.005),在24小时时分别降低53%(p<0.025)和56%(p<0.01),在48小时时分别降低41%(p<0.05)和44%(p<0.05)。(摘要截断于250字)

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