法舒地尔与地尔硫卓治疗心脏X综合征疗效比较

目的观察应用法舒地尔与地尔硫卓治疗心脏X综合征（CSX）患者的疗效。方法49例心脏X综合征患者随机接受法舒地尔（24例）或地尔硫卓（25例）治疗，随访治疗3个月后的临床情况并复查平板运动试验、冠状动脉血流储备（CFR），以及一氧化氮（NO）、血浆内皮素-1（ET-1）的含量。结果与本组治疗前比较，用药3个月后两组胸痛例数及最大ST段压低幅度明显减少，ET-1水平明显下降，CFR及NO水平明显升高，运动总时间、ST段压低1mm时间明显延长（P〈0．01，P〈0．05）。与地尔硫卓组相比，法舒地尔组胸痛例数及最大ST段压低幅度明显减少（均为P〈0．05），ET-1水平明显下降（P〈0．01），CFR及NO的水平明显升高（均为P〈0．05），运动总时间、ST段压低1mm时间明显延长（P〈0．01，P〈0．05）。结论法舒地尔与地尔硫卓均能改善CSX患者的内皮细胞功能，提高患者的运动耐量及CFR，且法舒地尔较地尔硫卓更为有效。

Comparison of fasudil and diltiazem in treting patients with cardiac X-syndrome

Objective To investigate the therapeutic effects of fasudil and diltiazem on patients with cardiac X-syndrome. Methods Forty-three patients with cardiac X-syndrome were randomly allocated into fasudil treated group （n=24） and diltiazem treated group （n=25） for three months. The clinical presentations, results of treadmill tests, coronary flow reserve （CFR）, and the levels of endothelin-l（ET-l） and nitro oxide （NO） were compared before and three months after treatment. Results After the 5-month therapy, chest pain, ST depression and the levels of ET-1 significantly decreased and CFR, the levels of NO significantly increased and total exercise duration, time to 1 mm ST segment depression were significantly longer （P〈0.01 or P〈0.05） in the two groups. Chest pain, ST depression and the levels of ET-1 significantly decreased, CFR and the levels of NO significantly increased（P〈0.05）. Total exercise duration and time to 1 mm ST segment depression were significantly longer（P〈 0.05 ） in fasudil group. Conclusion Fasudil has a better effect than diltiazem in the improvement of exercise tolerance for the patients with cardiac X-syndrome.