比索洛尔片与地尔硫■缓释胶囊治疗冠状动脉肌桥的对比研究

Comparative study of bisoprolol tablets and diltiazem sustained-release capsules treatment of coronary myocardial bridge

目的观察冠状动脉造影人群中冠状动脉肌桥的临床特点,比较比索洛尔片与地尔硫■缓释胶囊治疗有症状的心肌桥的效果。方法 2011年4月至2014年6月我院因胸痛收治的行冠状动脉造影的1 435例患者,共检出心肌桥86例,选取符合条件的43例,按随机数字表法分为2组。富马酸比索洛尔片(5 mg,1次/d)21例,盐酸地尔硫■缓释胶囊(合贝爽)(90 mg,1次/d)22例。记录两组治疗前后每月心绞痛症状发作次数,行运动试验。比较两组治疗效果。结果比索洛尔片组与地尔硫■缓释胶囊组均可减少心肌桥患者心绞痛症状发作次数、延长运动诱发心绞痛时间及延长运动后ST段下移1 mm的时间(均为P<0.05),但比索洛尔组较地尔硫■缓释胶囊组改善更明显(均为P<0.05)。结论比索洛尔片及地尔硫■缓释胶囊均可有效缓解心肌桥引起的心绞痛,且比索洛尔片疗效优于地尔硫■缓释胶囊。

Objective To investigate the clinical characteristics of coronary artery myocardial bridge and to compare the treatment effects by bisoprolol tablets and by diltiazem extended-release capsules. Methods A total of 43 patients with chest pain and diagnosed coronary myocardial bridge by coronary angiography were randomly divided into 2 groups： bisoprolol group （ n =21, patients accepted bisoprolol tablet 5mg daily） and diltiazem group （n=22,patients were given diltiazem sustained release capsule 90 mg daily） . Angina attacks per month and the results of exercise stress test were recorded before and after treatment,and compared between the two groups. Results The frequency and sustained time of angina attacks in both groups were significantly reduced after bisoprolol tablet or diltiazem sustained release capsule treatment,and exercise-induced angina time and ST segment depression time were improved in both groups （all P〈0. 05）,especially in bisoprolol group （all P〈0. 05）. Conclusions Both bisoprolol tablets and diltiazem sustained release capsules can effectively alleviate angina pectoris induced by coronary myocardial bridge and bisoprolol tablets seems more effective than diltiazem extended-release capsules.