贝那普利与地尔硫卓治疗心脏X综合征患者疗效的比较

Comparison of effect between benazepril and diltiazem in patients with cardiac X-syndrome

目的:观察贝那普利与地尔硫卓对心脏X综合征患者的疗效。方法:心脏X综合征患者45例接受贝那普利(22例,贝那普利组)或地尔硫卓(23例,地尔硫卓组)治疗,治疗3个月后随访临床情况并复查平板运动试验、冠状动脉血流储备(CFR)及血浆一氧化氮(NO)、血浆内皮素-1(ET-1)的含量。结果:用药3个月后贝那普利组和地尔硫卓组胸痛例数及最大ST段压低幅度明显减少(分别为P<0.01,P<0.05),ET-1水平明显下降(均P<0.01),血浆CFR及NO的水平明显升高(P<0.01或P<0.05),运动总时间、ST段压低1 mm时间明显延长(P<0.01或P<0.05)。与地尔硫卓组相比贝那普利组胸痛例数及最大ST段压低幅度减少更显著(均P<0.05),ET-1水平下降更显著(P<0.01),CFR及NO的水平升高更显著(均P<0.05),运动总时间、ST段压低1 mm时间延长更显著(分别为P<0.01,P<0.05)。结论:贝那普利与地尔硫卓均能改善心脏X综合征患者的内皮细胞功能提高患者的运动耐量及CFR,且与地尔硫卓相比贝那普利更为有效。

AIM： To investigate the effects of benazepril and diltiazem on patients with cardiac X-syndrome. METHODS： Forty five patients with cardiac X-syndrome were randomly allocated to be treated with benazepril （ Group A, n = 22） or with dihiazem （ Group B, n = 23 ） for 3 months. Clinical presentations, results of treadmill tests, coronary flow reserve （ CFR）, and levels of endothelin-1 （ET-1） and nitric oxide （NO） were compared before and 3 months after treatment. RESULTS： After the 3-month treatment, the number of episodes of chest pain, ST depression and levels of ET-1 significantly decreased （all P 〈0. 01 vs. before treatment）. CFR, as well as NO levels, significantly increased （all P 〈0. 01 vs. before treatment） and total exercise duration as well as time to 1 mm ST segment depression were significantly longer （all P 〈0.01 vs. before treatment） in benazepril group. After the 3-month treatment, the number of episodes of chest pain, ST depression and levels of ET-1 significantly decreased （all P 〈 0. 05 vs. before treatment）, CFR significantly increased （P 〈0.05） and total exercise duration as well as time to 1-mm ST segment depression were significantly longer （ all P 〈 0. 05 vs. before treatment） in dihiazem group. The number of episodes of chest pain, ST depression and the levels of ET-1 significantly decreased and CFR as well the levels of NO significantly increased （ all P 〈 0. 05 vs. dihiazem group） and total exercise duration as well as time to 1-mm ST segment depression were significantly longer （all P 〈 0. 05 vs. dihiazem group） in benazepril group. CONCLUSION： Benazepril may exert a more positive effect than dihiazem in the improvement of exercise tolerance for patients with cardiac X-syndrome.