维生素C对缺血性心脏病患者硝酸甘油24小时耐药性的影响

目的　探讨不同方法应用维生素C对缺血性心脏病 (IHD)患者硝酸酯耐药性的预防作用。方法　将 45例IHD患者随机分为 3组 (每组 15例 ) ,A组静滴硝酸甘油 (NG) ,B组静滴硝酸甘油并口维生素C ,C组静滴硝酸甘油和维生素C。在基础值测得后以 0 .4μg·kg-1·min-1的速度开始静滴硝酸甘油 ,逐渐调整滴速 ,直至得到所期望的数值维持。在基础测量时 ,3组心率 (HR)、血压 (BP)及心率与收缩压积 (HR×SBP)具有可比性 ,在静滴的第 0、6、12、18、2 4h连续监测HR及BP值。结果　在静滴 6h时 ,3组病例BP及HR×SPB值均明显降低 ,在静滴 18h时A组BP及HR×SBP明显回升 ,而在B组及C组上述数值尚能维持 ,与A组比较有显著差异 (P <0 .0 1～ 0 .0 5 )。结论　对IHD患者在连续应用NG治疗期间 ,静脉或口服VitC均可预防NG耐药性的进展

Effect of vitamine C on drug resistance of nitrglycerin in 24h in patients with ischemic heart disease

Objective To investigate the preventive effect of vitamine C on drug resistance of nitroglycerin(NG) in patients with ischemic heart disease(IHD).Methods Forty five IHD patients received randomly intravenous infusion NG(A group,n=15)or intravenous NG and oral vitamin C(B group,n=15)or intravenous NG and vitamin C(C group,n=15).After measurement of baseline levels,the NG was given by intravenous infusion at a rate of 0.4?μg·kg -1 ·min -1 ,dosage was regulated adequately untill stabilized desirably . Measuremnts of heart rate (HR)and blood pressure (BP)were performned serially at 0, 6, 12, 18 and 24h.At baseline ,the HR,BP and HR×SBP were comparable in the 3 groups .Results At 6h after the vitamine C infusion, BP and HR×SBP were all reduced obviously in 3 groups .At 18h after the titration,BP and HR×SBP were increased obviously in A group compared with B group and C group(P<0.01 and P<0.05 respectively). Conclusion Both the intravenous and oral vitamin C may prevent progress of drug resistance of NG in IHD patients.