Effects of Propranolol and Isosorbide Dinitrate on Exercise Performance and Adrenergic Activity in Patients with Angina Pectoris
Effects of Propranolol and Isosorbide Dinitrate on Exercise Performance and Adrenergic Activity in Patients with Angina Pectoris
复制标题
普萘洛尔和硝酸异山梨酯对心绞痛患者运动能力和肾上腺素能活性的影响
作者：
D. Battock;Héctor Álvarez;C. Chidsey
在一项单盲交叉研究中，对12例心绞痛患者在踏车上运动能力的客观变化和口服普萘洛尔、硝酸异山梨酯（ISD）以及普萘洛尔和ISD联合给药后的主观临床改善进行了评价。综合客观和主观评价显示，12名患者中有9名在普萘洛尔治疗后改善，10名患者中有7名在ISD治疗后改善，所有10名患者在药物联合治疗后改善。不同药物方案之间的客观改善差异不显著。然而，主观上，所有接受联合药物治疗的患者均明显改善。普萘洛尔或联合用药的患者在休息和运动时的压力-心率指数均下降约30%，而这些值在ISD时没有变化。普萘洛尔单独使用和与ISD联合使用在3+级疼痛时观察到运动诱导的S-T抑制显著减少。肾上腺素能活性，估计从血浆和尿中的儿茶酚胺，似乎增加了这些患者在药物治疗前，并在治疗过程中没有改变。结论是普萘洛尔，ISD，以及这些药物的组合都可以改善心绞痛患者的运动表现。虽然药物的组合不能显示出比单独使用任何一种药物产生更大的运动表现增加，但该组合产生了更大的整体临床改善。
Twelve patients with angina pectoris were evaluated in a single blind crossover study with respect to objective changes in exercise performance on the treadmill and subjective, clinical improvement on oral administration of propranolol, isosorbide dinitrate (ISD), and a combination of propranolol and ISD. Combined objective and subjective evaluations showed that nine of 12 patients improved on propranolol, seven of 10 on ISD, and all 10 on the combination of drugs. The differences in objective improvement between the various drug regimens were not significant. However, subjectively all patients on the combination of drugs improved markedly. The patients on propranolol or the combination had a decrease in pressure-rate index of about 30% both at rest and during exercise, while these values did not change on ISD. A significant reduction in exercise-induced S-T depression was observed with propranolol alone and in combination with ISD at grade 3+ pain. Adrenergic activity, estimated from plasma and urinary catecholamines, appeared to be increased in these patients before drug treatment and was not altered during treatment. It is concluded that propranolol, ISD, and the combination of these drugs all improve exercise performance in patients with angina. Although the combination of drugs could not be shown to produce a greater increase in exercise performance than either drug alone, the combination effected a greater overall clinical improvement.