Tzivoni D, Keren A, Benhorin J, Gottlieb S, Atlas D, Stern S
Am Heart J. 1983 Feb;105(2):262-6. doi: 10.1016/0002-8703(83)90525-2.
The selective alpha, blocker prazosin was used to abolish Prinzmetal's variant angina in six patients. All had had an acute transmural myocardial infarction, after which the anginal attacks with transient ST segment elevation developed, and three of them had already suffered from variant angina prior to the infarction. Therapeutic trials with high doses of nifedipine, verapamil, nitrates, beta blockers, and (in one case) phenoxybenzamine were ineffective in all six patients. Prazosin, 8 to 30 mg/day combined with low-dose nitrates or nifedipine completely abolished the attacks in four patients, markedly reduced their frequency and intensity in one patient, and had to be stopped in the sixth one because of hypotension and dizziness. Except for this last patient, the drug was well tolerated by all the others, and no changes in blood pressure were observed. In four patients discontinuation or reduction of prazosin resulted in exacerbation of symptoms, but its renewal was followed by disappearance of the attacks. Since the mean follow-up period in this study was 4 to 6 months, further evaluation appears necessary concerning the long-term effects of this drug in Prinzmetal's variant angina.
选用α1受体阻滞剂哌唑嗪治疗6例变异型心绞痛患者。所有患者均曾发生急性透壁性心肌梗死，此后出现伴有短暂ST段抬高的心绞痛发作，其中3例在梗死前即已患有变异型心绞痛。对这6例患者进行大剂量硝苯地平、维拉帕米、硝酸盐、β受体阻滞剂及（1例患者使用）酚苄明的治疗试验均无效。哌唑嗪，每日8至30毫克，联合小剂量硝酸盐或硝苯地平，使4例患者的心绞痛发作完全消失，使1例患者的发作频率和强度显著降低，而第6例患者因低血压和头晕不得不停用该药。除最后1例患者外，其他所有患者对该药耐受性良好，未观察到血压变化。4例患者停用或减量哌唑嗪后症状加重，但重新用药后发作消失。由于本研究的平均随访期为4至6个月，因此有必要进一步评估该药对变异型心绞痛的长期疗效。
