胺碘酮及硝酸异山梨酯治疗冠心病无症状心肌缺血伴室性期前收缩

目的:评价胺碘酮合用硝酸异山梨酯对冠心病无症状性心肌缺血(silentmyocardialischemia,SMI)伴室性期前收缩(prematureventricularcontraction,PVC)的治疗效果。方法:将99例冠心病SMI伴PVC患者随机分3组,其中A组32例口服胺碘酮加安慰剂;B组33例口服硝酸异山梨酯加安慰剂;C组34例口服胺碘酮和硝酸异山梨酯。前两者作为对照组,后者作为治疗组。评价内容包括血压、心率、二重乘积、PVC改善情况以及心电图ST段压低次数、ST段压低持续总时间、心肌缺血总负荷等。结果:99例中2例因口服硝酸异山梨酯后不能耐受而退出治疗,余97例完成疗程。3组用药后上述观察指标差异均有不同程度改善,其中以治疗组最明显。治疗组与两对照组比较,心率、二重乘积、PVC差异均有统计学意义(P<0.01),且治疗组用药前后自身比较上述指标也有统计学意义(P<0.01),SMI的发作次数以及其持续总时间显著减少(P<0.01),心肌缺血总负荷也显著降低(P<0.01)。治疗组和对照组比较,血压影响差异无统计学意义(P>0.05),未见明显不良反应。结论:胺碘酮合用硝酸异山梨酯治疗SMI伴PVC有效。     

联用复方丹参滴丸和硝酸异山梨酯治疗冠状动脉粥样硬化性心脏病心绞痛68例

目的：探讨联用复方丹参滴丸与硝酸异山梨酯治疗冠状动脉粥样硬化性心脏病（冠心病）心绞痛的临床疗效及对心功能的影响。方法：以临床症状、体表心电图、血液流变性和运动耐力试验等方法,观察单用复方丹参滴丸或单用硝酸异山梨酯及联用复方丹参滴丸与硝酸异山梨酯治疗冠心病心绞痛的疗效及其对心功能影响。结果：①复方丹参滴丸对冠心病心绞痛疗效与硝酸异山梨酯接近,两药合用的临床疗效（８５．３％）与心电图疗效（７５．０％）均优于单用复方丹参滴丸（６１．３％和５１．６％）或硝酸异山梨酯（７２．３％和５８．３％）,均有显著性差异（Ｐ＜０．０５或Ｐ＜０．０１）;②复方丹参滴丸可改善心绞痛患者血液流变性,增加心肌血供;减慢心率,降低心肌氧耗,以稳定心绞痛。结论：复方丹参滴丸对冠心病心绞痛有较好疗效;复方丹参滴丸与硝酸异山梨酯合用更适合血容量不足及对扩血管药物敏感的心绞痛老年患者     

硝酸异山梨酯注射液配伍应用效果及安全性研究

目的探讨硝酸异山梨酯注射液(消心痛)治疗不稳定性心绞痛(UA)时配伍用药的效果和安全性。方法57例不稳定性心绞痛患者随机分为2组。硝酸异山梨酯联合用药组(n=27):硝酸异山梨酯联合环磷腺苷葡甲胺(心先安)、门冬氨酸钾镁(潘南金),静滴,每天1次,连续10d;对照组(n=30):给予常规UA治疗。比较治疗前后心绞痛发作及心电图所示的心肌缺血和心律失常的改善情况,同时对消心痛、心先安、潘南金的配伍用药进行研究。结果硝酸异山梨酯联合用药组心绞痛发作频率减少,间隔时间延长,心率较治疗前减慢,与对照组比较均存在明显差异(P<0.01)。心电图ST段下移虽有抬高,但无统计学差异(P>0.05)。以上3种药物没有配伍禁忌。结论硝酸异山梨酯联合心先安和潘南金可以改善心肌缺血,减轻冠状动脉痉挛,减少心律失常的发生,副作用很少。     

通心络胶囊联合硝酸异山梨酯片治疗冠心病心绞痛60例

目的:观察通心络胶囊联合硝酸异山梨酯片治疗冠心病心绞痛的疗效。方法:120例冠心病心绞痛患者随机分为对照组和治疗组各60例,在常规治疗基础上,对照组给予硝酸异山梨酯片10 mg/次,3次/d,口服,治疗组在对照组治疗基础上给予通心络胶囊2粒/次,3次/d,口服,2组疗程均为3个月。比较2组疗效、心绞痛发作频率、发作持续时间、心电图改变、住院时间、出院后1周再住院率。结果:治疗组总有效率93.3%,对照组总有效率75.0%,2组比较差异有统计学意义(P<0.05)。2组治疗后心绞痛发作频率、发作持续时间均减少(P<0.05),治疗组改善优于对照组(P<0.05)。治疗组住院时间(8.6+2.3)d较对照组短(13.6+1.6)d(P<0.05),出院后1周再住院率8.3%(5/60)低于对照组16.6%(11/60)(P<0.05)。结论:通心络胶囊联合硝酸异山梨酯可改善冠心病心绞痛临床症状。     

联用复方丹参滴丸和硝酸异山梨酯治疗冠状动脉粥样硬？…

目的：探讨联用复方丹参滴丸与硝酸异山梨酯治疗冠状动脉粥样硬化性心脏病心绞痛的临床疗效及对心功能的影响。方法;以临床症状,体表心电图,血液流变性和运动耐力试验等方法,观察单用复方丹参滴丸或单用硝酸异山梨酯臁联用复方丹参滴丸与硝酸异山梨酯治疗冠心病心绞痛的疗效及其对心功能影响。结果：（１）复方丹参滴丸对冠心病心绞痛疗效与硝酸异山梨酯接近,两药合用的临床疗效与心电图疗效均优于单用复方丹参滴丸或硝酸异山梨     

心可舒联合硝酸异山梨酯治疗心绞痛的疗效观察

目的:观察心可舒联合硝酸异山梨酯治疗冠心病心绞痛的疗效。方法:80例冠心病心绞痛随机分为2组,其中治疗组40例,用心可舒4片,1d3次,联合硝酸异山梨酯片5mg,1d3次,共7d;对照组40例,用复方丹参片3片,1d3次,联合硝酸异山梨酯片5mg,1d3次,共7d。结果:治疗组临床疗效和心电图改善均优于对照组(P<0.05)。结论:心可舒联合硝酸异山梨酯治疗心绞痛的疗效优于复方丹参片联合硝酸异山梨酯,且前者副作用小。     

硝酸异山梨酯注射液配伍应用效果及安全性研究

目的 探讨硝酸异山梨酯注射液(消心痛)治疗不稳定性心绞痛(UA)时配伍用药的效果和安全性.方法 57例不稳定性心绞痛患者随机分为2组.硝酸异山梨酯联合用药组(n=27):硝酸异山梨酯联合环磷腺苷葡甲胺(心先安)、门冬氨酸钾镁(潘南金),静滴,每天1次,连续10 d;对照组(n=30):给予常规UA治疗.比较治疗前后心绞痛发作及心电图所示的心肌缺血和心律失常的改善情况,同时对消心痛、心先安、潘南金的配伍用药进行研究.结果 硝酸异山梨酯联合用药组心绞痛发作频率减少,间隔时间延长,心率较治疗前减慢,与对照组比较均存在明显差异(P＜0.01).心电图ST段下移虽有抬高,但无统计学差异(P＞0.05).以上3种药物没有配伍禁忌.结论 硝酸异山梨酯联合心先安和潘南金可以改善心肌缺血,减轻冠状动脉痉挛,减少心律失常的发生,副作用很少.     

5-单硝酸异山梨酯联合美托洛尔治疗冠心病心绞痛疗效观察

目的观察5单硝酸异山梨酯联合美托洛尔治疗心绞痛的疗效。方法采用随机、单盲法将59例心绞痛患者分为两组。治疗组30例,给予5单硝酸异山梨酯联合美托洛尔治疗;对照组29例,给予5单硝酸异山梨酯治疗;观察两组患者用药后各项指标的改善情况并进行比较。结果治疗组总有效率93.3%,对照组为58.6%,组间比较有显著性差异(P<0.01);治疗组心电图改善总有效率66.7%,对照组为40.7%,组间比较有显著性差异(P<0.05)。结论5单硝酸异山梨酯联合美托洛尔治疗心绞痛疗效优于单用5单硝酸异山梨酯。     

5-单硝酸异山梨酯治疗心绞痛疗效观察

目的比较 5 -单硝酸异山梨酯与硝酸异山梨酯治疗心绞痛的疗效。方法采用随机、单盲法将 178例心绞痛患者分两组。治疗组90例 ,给予 5 -单硝酸异山梨酯 ;对照组 88例 ,给予硝酸异山梨酯。结果治疗组总有效率 91.6 % ,对照组总有效率 76 .6 % ,组间比较有高度显著性差异 ( P<0 .0 1)。治疗组心电图改善总有效率 6 8.9% ,对照组总有效率 5 2 .7% ,组间比较有显著性差异 ( P<0 .0 5 )。结论 5 -单硝酸异山梨酯治疗心绞痛疗效优于硝酸异山酯     

普恩复胶囊与硝酸异山梨酯联合治疗冠状动脉粥样硬化性心脏病心绞痛的临床研究

目的：观察普恩复胶囊与硝酸异山梨酯合用治疗冠状动脉粥样硬化性心脏病（冠心病）心绞痛的疗效。方法：５８例冠心病心绞痛非发作期心肌缺血的患者，随机分为Ａ、Ｂ２组，Ａ组口服普恩复胶囊４００ｍｇ，每日３次，硝酸异山梨酯１０ｍｇ，每８小时１次；Ｂ组单纯口服硝酸异山梨酯１０ｍｇ，每８小时１次。２组均连用８周，评定疗效。结果：Ａ组第６周和第８周临床总有效率分别为９０．００％和９３．３３％，Ｂ组均为８２．１４％，２组比较均有显著性差异（Ｐ均＜０．０５）；心电图总有效率Ａ组第６周和第８周分别为７０．００％和７３．３３％，Ｂ组均为５７．１４％，２组比较均有显著性差异（Ｐ结论：普恩复胶囊与硝酸异山梨酯合用是治疗冠心病心绞痛的理想配伍用药     

大剂量硝酸异山梨醇酯抢救急性心源性肺水肿的疗效观察

目的探讨大剂量硝酸异山梨醇酯治疗急性心源性肺水肿的疗效。方法317例急性心源性肺水肿患者，分为实验组和对照组。实验组采用静脉注射大剂量硝酸异山梨醇酯注射液并且静脉滴注维持，对照组按传统疗法治疗。包括利尿．应用糖皮质激素、氨茶碱等。观察2组临床症状、动脉血压、血氧饱和度的变化。结果治疗后实验组有效率89．3％，对照组有效率70．4％（P〈0．01）。实验组在呼吸困难的缓解、肺部水泡音的减少、死亡人数以及血氧饱和度方面明显优于对照组，但2组在心率、呼吸频率上未见明显差异，治疗中均无急性心肌梗死出现，未见其他严重副作用。结论静脉注射大剂量硝酸异山梨醇酯抢救急性心源性肺水肿是一有效、安全的新疗法。     

四逆汤治疗对冠心病心绞痛患者生活质量的影响

背景在心绞痛患者的干预效果评估中,症状和体征改善的同时,其生活质量提高与否也是一个非常重要的因素.目的探讨经典方四逆汤对冠心病心绞痛的干预效果,比较单纯中药、西药及中西医结合对患者生活质量的影响.设计以冠心病心绞痛患者为研究对象的前瞻性观察对比研究. 单位一所大学医院的中医科.对象病例为2003-02/2003-08在中山大学附属第一医院中医科门诊就诊的冠心病心绞痛患者,共88例.纳入标准符合“心血管系统药物临床研究指导原则”和“冠心病中医辨证标准”者.排除标准合并各种严重疾病者.所有患者随机分为四逆汤组、消心痛组和联合用药组,各组分别为29,30和29例.方法四逆汤组、消心痛组和联合用药组分别用四逆汤、消心痛和四逆汤联合消心痛治疗.在治疗开始前及结束,观察心绞痛发作次数、条件、程度、持续时间,记录心电图,分别在患者服药前及服药两周应用统一的调查表和检测工具进行生活质量评分.主要观察指标各组控制心绞痛发作的疗效、心电图表现及患者的生活质量评分的比较.结果消心痛和四逆汤均能明显缓解患者心绞痛,改善心电图表现,从躯体症状、健康愉快感和抑郁水平三方面提高生活质量评分(P＜0.01),四逆汤提高以上三方面生活质量评分的效果好于消心痛(P＜0.01),但四逆汤和消心痛联合应用时临床疗效和生活质量(健康愉快感、抑郁水平)改善最优(P＜0.01).结论四逆汤在改善冠心病心绞痛患者生活质量方面具有优势,临床干预用药时,应该取中西医之长.     

Clinical effects of a sustained-release preparation of isosorbide dinitrate on angina pectoris

The antianginal action of a sustained-release preparation of isosorbide dinitrate (SUS-ID), administered twice a day, was examined in open trial in 61 patients with angina pectoris. The results obtained were as follows: 1) The frequency of anginal attacks as well as consumption of nitroglycerin tablets began to decrease significantly in the two weeks following the commencement of treatment with SUS-ID; increasing the dose and prolonging the period of administration resulted in further augmentation of its clinical effect. 2) The subjective symptoms improved in 44 of the 61 patients studied (72.1%), and 17 patients (27.9%) showed an improved electrocardiogram. 3) Both the systolic and diastolic blood pressures were significantly lowered, but little change in heart rate was observed. 4) According to the efficacy assessment by the doctors in charge, this drug was judged to be "effective and strongly recommendable" and to be "usable" in 56 of 61 patients (91.8%). Thus SUS-ID was considered to be of clinical usefulness. 5) In terms of side effects, 14 patients (23.0%) complained of headache and three patients (4.9%) of dizziness. These side effects, however, were not serious enough to cause withdrawal of the drug.     

Antianginal effect of isosorbide dinitrate spray in patients with exercise-induced stable angina

Ten patients with stable exercise-induced angina took part in this study. Isosorbide dinitrate and placebo sprays were administered in a double-blind, randomized crossover study. The dose of isosorbide dinitrate given was two squirts (= 2.5 mg) 2 min before testing. When taken before exercise it significantly improved (p less than 0.014) exercise tolerance. Significant (p less than 0.0005) ischaemic changes in the electrocardiogram also occurred. These effects occurred later than with placebo. Exercise time was prolonged with the active drug. The results of this study show that isosorbide dinitrate spray improves the exercise tolerance of patients with ischaemic heart disease.     

Comparative study of isosorbide dinitrates and mononitrates in patients with ischemic heart disease and stable angina pectoris caused by stenosing coronary atherosclerosis

In an open clinical trial 19 patients with angina pectoris (functional class II-III) received in turn either non-retard tablets of isosorbide dinitrate (nitrosorbid, cardiket) in a mean dose 80 mg/day or isosorbide 5-mononitrate (mono mac) in a mean dose 51.5 mg/day. Each drug was given for a month. The effect was assessed by changes in frequency of anginal attacks and exercise tolerance. Non-retard isosorbide dinitrate and isosorbide 5-mononitrate demonstrate a good antiischemic effect, are safe and well tolerated. Isosorbide dinitrate and mononitrates do not differ significantly in reduction of the anginal attacks and by an increase in exercise tolerance but the effective dose of mono mac was 1.5-2 times less than that of nitrosorbide or cardiket, thus it is more cost-effective.     

地尔硫(艹卓)治疗冠状动脉造影术前围手术期不稳定型心绞痛临床研究

目的 探讨地尔硫[艹卓]治疗冠状动脉造影前围手术期心绞痛的临床疗效和安全性。方法 对106例围手术期心绞痛患者静脉应用地尔硫[艹卓]，观察心绞痛发作次数、血压、心率和心肌耗氧指数的变化，判断疗效。结果 82例（77．4％）用药期间未再发作，另有24例（22．6％）仍有心绞痛发作，但程度减轻。用药1、24和48h时心率、收缩压、舒张压和心肌耗氧指数与用药前相比均下降（均P〈0．05）。无一例因严重不良反应而停药。结论 静脉应用地尔硫[艹卓]治疗冠状动脉造影前围手术期不稳定型心绞痛安全、有效。     

Early administration of isosorbide dinitrate improves survival of cyanide-poisoned rabbits

Abstract

Context. More effective, rapidly delivered, safer antidotes are needed for cyanide poisoning. Previous study has demonstrated a beneficial effect of isosorbide dinitrate on the survival of cyanide-poisoned mice. Objective. To evaluate the effectiveness of isosorbide dinitrate compared with that of sodium nitrite in cyanide poisoning. Materials and methods. A comparative animal study was performed using 18 rabbits, randomized into 3 study groups. Animals were poisoned intravenously with potassium cyanide (1 mg/kg). The first group was not given any further treatment. The second and third groups were treated intravenously 1 min after poisoning with sodium nitrite (6 mg/kg) and isosorbide dinitrate (50 μg/kg), respectively. The primary outcome was short-term survival of up to 30 min. Secondary outcomes included time to death, a clinical score, mean blood pressure, pulse, blood pH, and lactate and methemoglobin levels. Results. Rabbits treated with isosorbide dinitrate or sodium nitrite survived while only one untreated rabbit survived. Median time to death of the 5 poisoned and untreated animals was 10 min. All the animals collapsed soon after poisoning, exhibiting rapidly disturbed vital signs and developed lactic metabolic acidosis; average peak blood lactate levels were 15.5–19.1 mmol/L at 10 min after poisoning. The treated animals improved gradually with practically full recovery of the clinical scores, vital signs, and blood gas levels. Sodium nitrite administration raised methemoglobin to an average peak of 7.9%, while isosorbide dinitrate did not change methemoglobin levels. Conclusion. Early administration of isosorbide dinitrate improved the short-term survival of cyanide-poisoned rabbits. Isosorbide dinitrate shows potential as an antidote for cyanide poisoning and may exert its effect using a nitric-oxide-dependent mechanism.     

The comparison of the efficacy of atenolol and isosorbide dinitrate therapy in chronic hypotension patients with stable angina pectoris

Antianginal efficacy of atenolol (A) and isosorbide dinitrate (ID) was compared in a long-term randomized, single-blind, crossover, placebo controlled trial in 71 patients with combined stable angina pectoris and chronic hypotension (Hpts) and in 38 normotensive patients with angina of effort (Npts). Paired bicycle tests showed anti-ischemic activity of drugs: A in 75% and ID in 49% of Hpts, A in 83% and ID in 82% of Npts. Antianginal effect of 25 mg A was observed in 49% of Hpts (vs 6% of Npts; p < 0.01). Secondary resistance to A effect was developed on the treatment week 2-4 in 13% of Hpts (vs 0 in Npts) tolerance to ID effect--on week 1-2 in 71% of Hpts (vs 15% of Npts; p < 0.01) as evidenced by T1-199 exercise myocardial scintigraphy. Hpts needed individual ID therapy with a long-term ID-free period during 8-16 days (vs 3-5 in Npts; p < 0.05) to avoid tolerance. Stable antianginal ID effect manifested with a decrease of myocardial perfusion defect size by 43.1 +/- 1.3% (p < 0.05).     

Effects of bisoprolol and isosorbide dinitrate on the circadian distribution of myocardial ischemia

The effects of bisoprolol 10 mg once daily, isosorbide dinitrate (ISDN) 20 mg three times daily, or a combination of these drugs on ischemia during exercise testing and on the occurrence and the circadian variation of ischemia during ambulatory monitoring were evaluated in 23 patients with stable angina pectoris. ISDN and bisoprolol monotherapies both significantly reduced the number of patients with angina pectoris and ST-depression during ergometry while lengthening the time to occurrence of 0.1-mV ST-depression. ISDN did not reduce the number of ischemic episodes measured by Holter monitoring, although it did significantly reduce the duration of ischemia. Bisoprolol monotherapy and combination therapy significantly reduced the number of ischemic episodes as well as the duration of ischemia, total ischemic burden, and number of anginal attacks. The circadian variation of ischemia as measured by Holter monitor was completely abolished by bisoprolol monotherapy and by combination therapy. ISDN monotherapy reduced the evening peak of ischemia but only shortened the morning peak. Both bisoprolol and ISDN reduced ischemia during formal exercise testing, but only bisoprolol effectively reduced the total amount of daily life ischemia as measured by ambulatory monitoring.     

地尔硫(艹卓)革治疗缺血性心肌病患者心绞痛疗效观察

目的探讨口服地尔硫治疗缺血性心肌病(ICM)患者心绞痛(ICM-AP)的临床疗效。方法72例ICM-AP患者随机分为两组,对照组30例给予常规抗心绞痛、纠正心衰治疗,地尔硫组42例在以上常规治疗基础上给予地尔硫15~30 mg,每日4次,分别于9:00、15:00、21:00、3:00时间点口服,疗程2周。对比观察两组心绞痛改善程度和心电图变化,以及药物对心率、血压和心功能的影响。结果地尔硫组治疗心绞痛的临床总有效率高于对照组(P<0.05),两组心功能改善等级比较差异无统计学意义(P>0.05),两组血压比较差异无统计学意义(P>0.05),地尔硫组心率低于对照组(P<0.05)。结论口服地尔硫治疗ICM-AP安全有效。