氟伐他汀加用地尔硫卓对心脏X综合征患者的治疗效果

Effect of Diltiazem in patients with cardiac X-syndrome

目的观察地尔硫卓治疗心脏X综合征患者的疗效。方法将47例心脏X综合征患者随机接受氟伐他汀(23例,氟伐他汀组)或氟伐他汀+地尔硫卓(24例,联合用药组)治疗,随访治疗3个月后的临床情况并复查平板运动试验及一氧化氮(NO)、血浆内皮素-1(ET-1)的含量。结果各组用药后平板运动试验到达终点时间均显著延长(氟伐他汀组P<0.05;联合用药组P<0.01)。两组临床胸痛发生率及平板运动试验阳性率均显著降低(均P<0.01)。NO、HDL-C水平明显升高,TC、TG、LDL-C、ET-1水平明显下降。与对照组相比联合用药组平板运动试验中到达运动终点时间显著延长(P<0.05),临床胸痛发生率显著降低(P<0.05)。结论氟伐他汀能明显改善X综合征患者的内皮细胞功能,加用地尔硫卓更能提高患者的运动耐量及缓解临床症状。

AIM To investigate the effects of Fluvastatin or Fluvastatin plus Diltiazem on patients with cardiac X-syndrome. METHODS Forty-seven patients with cardiac X-syndrome were randomized to receive Fluvastatin （ F Group, 23 cases） and Dihiazem （ F ＋ D Group, 24 cases）. The clinical presentations, results of treadmill tests, NO and ET-1 after 3 months of treatment were compared between the two groups. RESULTS After a 3-month treatment, the duration of treadmill （ F Group, P 〈 0.05 ; F ＋ D Group, P 〈 0.01 ） significantly increased. The number of patients with chest pain （ F Group , P 〈 0.01 ; F ＋ D Group, P 〈 0.01 ） and positive treadmill test （ F Group, P 〈 0.01 ; F ＋ D Group, P 〈 0.01 ） significantly decreased. The levels of NO and HDL-C significantly increased and the levels of TC, TG, LDL-C and ET-1 significantly decreased. Compared with that in control Group, the duration of treadmill of study group was much longer （ P 〈 0. 05 ） and the number of patients with chest pain （ P 〈 0. 01 ） significantly decreased. CONCLUSION Fluvastatin may significantly improve the function of endothelium for the patients with cardiac X-syndrome. Fluvastatin plus Diltiazemin may exert better effect than Fluvastatin in improving exercise tolerance and clinical presentations.