硝酸甘油软膏与膜剂对冠心病患者左室功能的影响

THE EFFECTS OF PERCUTANEOUS NITROGLYCERIN ON LEFT VENTRICULAR FUNCTIONS IN PATIENTS WITH CORONARY HEART DISEASE

硝酸甘油软膏与膜剂贴敷后对冠心病患者左室射血分数及相对心输出量较贴敷前或安慰剂有明显增加(P<0.001),其中以软膏作用为强,提示经皮肤吸收的硝酸甘油制剂可改善左心室功能。

Left ventricular ejection fraction (LVEF) and relative cardiac outptut (RCO) were measured with nuclear stethoscope in 21 cases of coronary heart disease documented by coronary angiography. Patients were treated by single dose of 1% nitroglycerin ointment 10mg (1% Noin 10mg), nitroderm-TTS 5 or 10 (NTTS 5 or 10), and placebo with double-blind random control. The interval between two studies was 48 h to 72 h. Comparing with pretreatment level, the elevation of LVEF after 1% Noin 10mg ranged from 4.1 to 10.1% (P<0.01-0.001) at 30-120 minutes and NTTS^(10) from 5.5 to 5.7% (P<0.01) at 30-90 minutes while that of RCO after 1% Noin 10mg from 4.39 to 6.27 EDV/sec (P<0.01) at 30-90 minutes, but NTTS 10 showed no changes. The changes of LVEF and RCO after NTTS 5 and placebo were not significant. The increases of LVEF and RCO following 1% Noin 10mg were statistically significant (P< 0.01-0.001) in comparing with those after NTTS 5 and placebo in 10 patients. There were no significant differences between the changes of LVEF and RCO with 1% Noin 10mg and NTTS 10 in 11 patients. It suggests that percutancous nitroglycerin (1% Noin 10mg and NTTS^(10)) can improve left ventricular function of patients with coronary heart disease.