钙拮抗剂联合应用治疗不稳定性心绞痛

COMBINATION OF CALCIUM CHANNEL BLOCKERS FOR TREATING UNSTABLE ANGINA PECTORIS

本研究观察了２５８例不稳定性心绞痛患者，其中１０５例在硝酸酯类、β受体阻断剂、肝素等基础上选用两种钙拮抗剂联合治疗，１５３例在其它治疗基础上选择单一钙拮抗剂治疗。以心绞痛的分级改善及心电图ＳＴＴ改变为观察指标。结果发现：治疗１周时，对劳累性心绞痛（包括初发和恶化劳累性心绞痛），钙拮抗剂联合治疗组的显效率、总有效率明显高于单一钙拮抗剂组（Ｐ＜０．０５）。两周时两组间总有效率无明显差异。对自发性心绞痛和混合性心绞痛，联合治疗组１周及２周的显效率、总有效率均明显高于单一用药组（Ｐ＜０．０５）。钙拮抗剂联合应用，剂量大时偶有窦缓、房室传导阻滞、心衰等副作用，但停药或减量后很快恢复。研究表明：自发性和混合性心绞痛最好选用两种钙拮抗剂联合治疗。

cases of unstable angina pectoris were treated including 105 patients by combination of two kinds of calcium channel blockers,and 153 patients by one kind of calcium channel blocker,along with nitroglcycerin,β-receptor blocker and heparin and so on. The improvement of angina pectoris grade and changes of ST-T on ECG were observed. The results showed that for exertional angina pectoris after 1 week the treatment was more effective in two kinds of calcium channel blockers treated group than in one kind of calcium channel blocker treated group. But after 2 weeks there was no difference. In spontaneous and mixed angina pectoris groups,the treatment with two kinds of calcium channel blockers was more effective than in the group treated by one calcium channel blockers after 1～2 weeks.When treated by two kinds of large dose of calcium channel blockers,side effects such as sinns bradycardia,A-V conduct block and heart failure occasionally occurred and recovered as soon as the drug decreased in dose or discontinued.The result shows combinating two kinds of Ca 2+ channel blockers is the best way for treating spontaneous and mixed angina pectoris.