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。     

硝酸异山梨酯注射液治疗心绞痛静脉滴注速度的研究

目的：探讨静脉滴注硝酸异山梨酯注射液治疗心绞痛的适宜速度，减少在滴注过程中不良反应的发生。方法：将150例心绞痛患者随机分为A、B、C三组，爱倍20mg加入5％葡萄糖注射液500ml中静脉滴注1次／d三组，滴速分别为10滴／min，20滴／min，30滴／min，观察其疗效及不良反应，疗程均为10d。结果：三组临床效果无显著差异（P〉0．05），不良反应发生率有显著差异（P〈0.05）。结论：应用爱倍治疗心绞痛时，静滴以20滴／min左右较适宜，其不良反应少，输液时间适中，患者易于接受。     

硝酸异山梨酯注射液治疗心绞痛静脉滴注速度的研究

目的:探讨静脉滴注硝酸异山梨酯注射液治疗心绞痛的适宜速度,减少在滴注过程中不良反应的发生。方法:将150例心绞痛患者随机分为A、B、C三组,爱倍20mg加入5%葡萄糖注射液500ml中静脉滴注1次/d三组,滴速分别为10滴/min,20滴/min,30滴/min,观察其疗效及不良反应,疗程均为10d。结果:三组临床效果无显著差异(P>0.05),不良反应发生率有显著差异(P<0.05)。结论:应用爱倍治疗心绞痛时,静滴以20滴/min左右较适宜,其不良反应少,输液时间适中,患者易于接受。     

硝酸异山梨酯注射液治疗心绞痛静脉滴注速度的研究

目的探讨静脉滴注硝酸异山梨酯注射液治疗心绞痛的适宜速度,减少在滴注过程中不良反应的发生.方法将150例心绞痛患者随机分为A、B、C三组,爱倍20mg加入5%葡萄糖注射液500mi中静脉滴注1次/d三组,滴速分别为10滴/min,20滴/min,30滴/min,观察其疗效及不良反应,疗程均为10d.结果三组临床效果无显著差异(P＞0.05),不良反应发生率有显著差异(P＜0.05).结论应用爱倍治疗心绞痛时,静滴以20滴/min左右较适宜,其不良反应少,输液时间适中,患者易于接受.     

硝酸异山梨酯注射液治疗充血性心力衰竭疗效观察

目的 观察硝酸异山梨酯注射液治疗充血性心力衰竭的疗效.方法 选择漯河市中医院重症监护室充血性心力衰竭患者40例,在常规治疗基础上应用硝酸异山梨酯注射液20 mg加入5%葡萄糖或生理盐水250 ml静脉滴注,1次/d,10~20滴/min,连续应用7~10 d.治疗前后检测心力衰竭标志物N-末端脑利钠肽（Nt-proBNP）并经超声心动图检查测量心排出血量（CO）、左室缩短率（FS）及射血分数（EF）.结果 显效14例（35%）,有效22例（55%）,无效4例（10%）,总有效率为90%.治疗前后CO、FS、EF及Nt-proBNP比较差异有统计学意义（P〈0.01）.结论 硝酸异山梨酯注射液治疗充血性心力衰竭效果显著且安全性较好,应用时需注意给药方式.     

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     

硝酸异山梨酯注射液治疗肺心病所致心力衰竭疗效观察

目的：探讨基层医院临床诊疗中对慢性肺源性心脏病所致心力衰竭的治疗方案。方法：136例慢性肺源性心脏病所致心功能分级达Ⅳ级的心力衰竭的患者，在共同应用血管紧张素转换酶抑制剂和利尿剂的基础上，分两组分别选用硝酸异山梨酯注射液和酚妥拉明注射液治疗，观察两种药物治疗效果的差别。结果：A组硝酸异山梨酯注射液治疗慢性肺源性心脏病所致心力衰竭的有效率明显高于B组；A组的不良反应发生率低于B组。     

应用二硝酸异山梨酯治疗不稳定型心绞痛的护理

198 8年至 2 0 0 2年我们对门诊确诊为不稳定型心绞痛的 110例患者中 5 8例应用二硝酸异山梨酯 (异舒吉 )治疗 ,效果满意 ,现将结果报告如下。1　资料与方法1 1　临床资料　不稳定型心绞痛 110例均按WHO推荐的冠心病命名及诊断标准作出诊断 ,随机分为异舒吉静脉组 (观察组 ) 5 8例 ,男 38例 ,女2 0例 ,平均 6 2岁 ;初发劳累性心绞痛10例 ,恶化型 5例 ,自发性 13例 ,有高血压病史 10例 ,发作时ST -T抬高 15例 ,发作时心律失常 5例。对照组 5 2例 ,男 37例 ,女 15例 ,平均 5 8岁 ;初发劳累性心绞痛 9例 ,恶化型 1例 ,自发性 13例 ,有高血压…     

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？…

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经心脏病（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组口服普昨胶囊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线第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     

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.     

静脉滴注5-单硝酸异山梨酯治疗不稳定型心绞痛的疗效评价

目的评价静滴 5 单硝酸异山梨酯 (IS 5 MN)对不稳定型心绞痛的疗效。方法 6 9例不稳定型心绞痛患者随机分为两组 :治疗组以IS 5 MN 4 0mg d治疗 ;对照组以硝酸甘油 (NTG) 2 0mg d治疗。结果IS 5 MN组临床疗效总有效率 94 .4 % ,NTG组总有效率75.8% (P <0 .0 5)。两组均能降低心肌氧耗指数及ECG的∑ST ,且IS 5 MN能增加UCG心功能指标。结论静滴IS 5 MN比NTG更能有效地改善不稳定型心绞痛患者的症状和心电图缺血变化 ,且IS 5 MN有改善心功能作用     

联用天保宁与消心痛治疗心绞痛临床疗效观察

目的：探讨联用天保宁与消心痛治疗心绞痛的疗效。方法：将１５５例冠状动脉粥样硬化性心脏病（冠心病）心绞痛患者随机分为３组，天保宁组５０例（Ａ组），消心痛组５０例（Ｂ组），联用天保宁与消心痛组５５例（Ｃ组）。Ａ组口服天保宁２片，每日３次；Ｂ组口服消心痛１０ｍｇ，每日３次；Ｃ组口服天保宁２片，消心痛１０ｍｇ，每日各３次，服药３周为１个疗程。结果：治疗１个疗程后Ａ、Ｂ、Ｃ３组临床症状改善的总有效率依次为７２．０％、７０．０％和９０．９％（Ｐ＜０．０２５和Ｐ＜０．０１）。心电图总有效率依次为６８．０％，７０．０％和９０．９％（Ｐ均＜０．０１）。结论：联用天保宁与消心痛治疗冠心病心绞痛患者的心绞痛症状改善及心电图心肌缺血改善均明显优于单独用天保宁组或单独用消心痛组。     

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).     

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.     

硝酸酯类制剂对不稳定型心绞痛的疗效及安全性

目的 为进一步探究硝酸酯类制剂治疗不稳定型心绞痛的临床疗效及安全性,以达到合理使用硝酸酯类制剂的目的.方法 回顾性分析我院2008-04-2012-01收治入院的不稳定型心绞痛患者100例临床资料,根据入院时间先后分为两组,每组50例,治疗组给予单硝酸异山梨酯片,对照组给予阿司匹林片.两组疗程均为4周.观察两组治疗前后临床疗效和心电图变化等情况,检测心功能指标,并予治疗后随访,记录药物的不良反应.结果 两组患者治疗4周后,治疗组总有效46例(92 0％);对照组总有效35例(70.0％),两组临床疗效比较,差异有统计学意义(x2=4.826,P＜0.05);治疗组治疗后每搏量(SV)、心排血量(CO)、左室射血分数(LEVF)值明显高于对照组治疗后,且差异有统计学意义,P＜0.05:两组治疗后均无肝、肾功能异常.结论 硝酸酯类制剂治疗不稳定型心绞痛患者安全、有效.治疗时应注意合理使用药物,以达到良好的治疗效果.     

Pharmacokinetics of diltiazem in patients with unstable angina pectoris

The pharmacokinetics of diltiazem and its major metabolites, deacetyldiltiazem and N-monodemethyl-diltiazem, were studied after single and chronic oral administration in eight patients aged 45 to 69 years with unstable angina pectoris, treated by diltiazem, 120 mg t.i.d. After a single oral dose the time to peak plasma diltiazem concentration was 3.4 (2.1 to 5.0) hours and the elimination half-life was 6.6 hours (4.4 to 10.8 hours). These were unchanged after repeated oral administration (16 to 19 doses). The mean trough (8 hours after administration) plasma diltiazem level after six consecutive doses was 167 micrograms/L (63 to 286 micrograms/L) and was thereafter stable. With chronic administration the AUC increased by a factor of 2.24 +/- 0.31 (SEM; P less than 0.01). Plasma protein binding of diltiazem in these patients ranged from 83% to 93% whereas deacetyldiltiazem binding ranged from 58% to 75%. Plasma protein binding was independent of drug concentration and duration of treatment. Thus an average dose of 120 mg diltiazem given every 8 hours would appear to be a suitable regimen of treatment in most patients with angina pectoris, although users should be aware that there is a significant interpatient variability in steady-state diltiazem concentrations and that a significant accumulation of diltiazem occurs with chronic therapy.     

曲美他嗪治疗不稳定型心绞痛的疗效观察

目的　观察在常规治疗基础上加用曲美他嗪治疗不稳定型心绞痛的疗效。方法　 10 3例确诊为不稳定型心绞痛的患者被随机分为两组 ,常规治疗组 5 1例 ,接受硝酸酯类、钙离子阻滞剂、血管紧张素转换酶抑制剂、β受体阻滞剂和抗血小板药物治疗。曲美他嗪组 5 2例 ,在常规治疗基础上加用曲美他嗪。两组治疗时间均为 (2 8± 2 )天。观察两组症状、心率、血压、动态心电图的变化及副作用。结果　与常规治疗组比较 ,曲美他嗪组的疗效更好 ,差异有统计学意义 (P <0 .0 1) ;曲美他嗪对心率、血压和率压乘积无影响 ;曲美他嗪组缺血发作次数、ST段最大下降幅度、总缺血时间的减少更为明显 ,差异均有统计学意义 (均P <0 .0 1)。结论　在常规治疗基础上加用曲美他嗪能更有效地改善不稳定型心绞痛症状 ,明显减少缺血发作次数、ST段最大下降幅度和总缺血时间。对血流动力学无影响。不良反应轻。是安全、有效、更完善的治疗方案