卡维地洛与地尔硫对X综合征伴冠状动脉血流储备异常患者疗效的对比研究

Comparison of the effect between carvedilol and diltiazem in patients with cardiac X-Syndrome and abnormal coronary flow reserve

目的 比较卡维地洛与地尔硫对伴冠状动脉血流储备减低心脏X综合征患者的疗效。方法 30例心脏X综合征且冠状动脉血流储备减低患者随机接受卡维地洛 (15例 ,卡维地洛组 )或地尔硫治疗 (15例 ,地尔硫组 ) ,随访治疗 3个月后的临床情况并复查平板运动试验。结果用药后两组平板运动试验到达终点时间明显延长 [卡维地洛组 :(7 2± 1 2 ) ,min和 (5 4± 0 8)min ;地尔硫组 :(5 3± 1 8)min和 (4 6± 1 1)min ,P均 <0 0 5 ]。卡维地洛组用药后临床胸痛 (用药前后分别为 :15例和 5例 ,P =0 0 0 1)、平板运动试验阳性 (用药前后分别为 :15例和 6例 ,P =0 0 0 1)显著减少 ;与地尔硫组比较 ,卡维地洛组平板运动试验中血压心率乘积减小 (175± 19和 196± 19,P <0 0 5 ) ,到达运动终点时间显著延长 [(7 2± 1 2 )min和 (5 3± 1 8)min ,P <0 0 5 ]。结论 卡维地洛能提高心脏X综合征患者的运动耐量 ,且较地尔硫更为有效。

Objective To compare the effects of Carvedilol and Diltiazem on patients with cardiac X syndrome and abnormal coronary flow reserve (CFR) Methods Thirty patients with cardiac X syndrome and abnormal CFR were randommized to receive Carvedilol (Group A, 15 cases) and Diltiazem (Group B, 15 cases) The clinical presentations and results of treadmill tests after 3 months of treatment were compared between the two groups Results In group A, the number of patients with chest pain(15 cases before vs 5 cases after, P =0 001), positive treadmill test (15 cases before vs 6 cases after, P =0 001)was significantly decreased and less angina episodes happened during treadmill(2 vs 7, P <0 05) at 3 months later Compared with group B, the duration of treadmill of group A patients were much longer [(7 2±1 2] min vs (5 3±1 8) min, P <0 05] The rate pressure product was lower in group A than that in group B(175±19 vs 196±19, P <0 05) The rate pressure product was lower in group A than that in group B(175±19 vs 196±19, P <0 05) Conclusion Carvedilol may exert a better effect than Diltiazem in the improvement of exercise tolerance for the patients with cardiac X syndrome