[异搏定与地尔硫䓬治疗稳定型劳力性心绞痛的比较：交叉双盲研究中的运动试验评估]

[Isradipine versus diltiazem in the treatment of stable effort angina pectoris: ergometric evaluation in a crossover double-blind study].

作者信息

Perticone F, Borelli D A, Maio R, Costa R, Pugliese F, Torchia L, Caristo S, Mattioli P L

机构信息

Dipartimento di Medicina Sperimentale e Clinica di Catanzaro, Università di Reggio Calabria.

出版信息

G Ital Cardiol. 1994 Nov;24(11):1395-402.

PMID:7828793

Abstract

OBJECTIVES

To evaluate the effects of isradipine (ISR) and diltiazem (DIL) on exercise tolerance and ischemic ST depression in patients with stable effort angina.

METHODS

Fourteen out-patients, 9 males and 5 females, aged 46-65 years (mean +/- SD = 57 +/- 8), with ischemic heart disease and reproducible ST-segment depression on two consecutive exercise stress tests in baseline conditions, underwent a study consisting of 4 periods: 1 and 3 placebo, 2 and 4 at random ISR (5 mg b.i.d.) and DIL (120 mg b.i.d.). At the end of each period a multistage treadmill exercise stress test (Bruce protocol) was performed.

RESULTS

Both drugs significantly (p < 0.001) increased ischemia time (IT) (0.1 mV ST depression) as compared to placebo, from 438 +/- 132 s. to 620 +/- 164 s. (ISR) and 583 +/- 147 s. (DIL) without statistical difference between two drugs (p = 0.2), and significantly reduced (p < 0.002) the maximal ST depression, from -0.20 +/- 0.11 mV to -0.07 +/- 0.07 mV (ISR) and -0.09 +/- 0.11 mV (DIL). At the IT, systolic blood pressure increased (p = 0.02), from 180 +/- 19 mm Hg to 187 +/- 15 mm Hg (ISR) and 191 +/- 15 mm Hg (DIL); similarly, heart rate increased from 133 +/- 24 bpm to 144 +/- 18 bpm (ISR: p = 0.002) and 140 +/- 17 bpm (DIL: p = NS).

CONCLUSIONS

ISR and DIL, at the above dosage have showed an important and significant anti-ischemic effect (IT = +41.5% during ISR and +33.1% during DIL).

摘要

目的

评估伊拉地平（ISR）和地尔硫䓬（DIL）对稳定型劳力性心绞痛患者运动耐量和缺血性ST段压低的影响。

方法

14例门诊患者，9例男性，5例女性，年龄46 - 65岁（平均±标准差=57±8），患有缺血性心脏病且在基线条件下连续两次运动负荷试验出现可重复性ST段压低，接受了一项包含4个阶段的研究：第1和第3阶段为安慰剂，第2和第4阶段随机给予ISR（5mg，每日两次）和DIL（120mg，每日两次）。在每个阶段结束时进行多级平板运动负荷试验（Bruce方案）。

结果

与安慰剂相比，两种药物均显著（p<0.001）增加了缺血时间（IT）（ST段压低0.1mV），从438±132秒增加到620±164秒（ISR）和583±147秒（DIL），两种药物之间无统计学差异（p = 0.2），并且显著降低（p<0.002）了最大ST段压低，从-0.20±0.11mV降至-0.07±0.07mV（ISR）和-0.09±0.11mV（DIL）。在缺血时间时，收缩压升高（p = 0.02），从180±19mmHg升至187±15mmHg（ISR）和191±15mmHg（DIL）；同样，心率从133±24次/分钟升至144±18次/分钟（ISR：p = 0.002）和140±17次/分钟（DIL：p =无显著性差异）。