硝苯地平控释片对无痛性心肌缺血病人左心功能的影响

Effects of nifedipine controlled release tablet on cardiac function in patients with silent myocardial ischemia

目的：观察硝苯地平控释片（Ｎｉｆ－ＣＲ）治疗无痛性心肌缺血（ＳＭＩ）时对左心功能的影响。方法：３６例ＳＭＩ病人（男性２３例，女性１３例；年龄５６±ｓ７ａ）采用Ｎｉｆ－ＣＲ２０ｍｇ，ｐｏ，ｑ１２ｈ×３ｗｋ。结果：（１）舒张压从１２５±２．３ｋＰａ下降至９．７±２．３ｋＰａ（Ｐ＜０．０５）；缺血型ＳＴ段压低明显改善（从１．６±０．７ｍｍ升至１．０±０．６ｍｍ）（Ｐ＜０．０１）。（２）核素心功能检测，ＬＶＥＦ，ＳＶ，ＥＲ，ＰＦＲ及ＲＣＯ均显著改善（Ｐ＜０．０５或Ｐ＜０．０１）。（３）治疗后ＰＲＡ和ＡＮＧⅡ水平降低（Ｐ＜０．０５）。结论：Ｎｉｆ－ＣＲ的持久血药浓度可改善左心功能，降低血压。不良反应小。

AIM : To observe the effects of nifedipine controlled release(Nif-CR) tablet on left cardiac function in patients with silent myocardial ischemia. METHODS: Thirty-six patients(M 23, F 13; age 56± s 7 a) were given Nif-CR 20 mg,po, q 12 h for 3 wk. RESULTS : After the treatment HR and SBP decreased moderately, DBP and MAP decreased markedly(P<0.05); the ischemic ST segments in ECG improved obviously(from 1.6± 0.7 mm to 1.0± 0.6 mm)(P<0.01); the nuclide cardiac function tests showed increasing LVEF(left ventricular ejection fraction), SV(stroke volume), ER(ejection rate), PFR(peak filling rate), and RCO(relative cardiac output)(P< 0.05,or P < 0.01); before treartment the plasma PRA(plasma renin activity)and ANG Ⅱ(angiotensin Ⅱ) level were elevated,after treatment were lowered down (P < 0.05). CONCLUSION: The sustained blood concentration of Nif-CR can improve left cardiac function and lower blood pressure. The adverse reaction are mild.