二氢吡啶类钙拮抗剂长期使用增加死亡危险的可能性及有关机制  

THE POSSIBILITY AND RELATED MECHANISMS OF THE INCREASED MORTALITY RATE CAUSED BY DIHYDROPYRIDINE CALCIUM ANTAGONISTS AFTER LONG-TERM USE

作　　者：戴德哉[1] 黄舰[1] 王红兰[1] 龚小健[1] 陆朝华[1] 

机构地区：[1]中国药科大学药理研究室

出　　处：《中国临床药理学杂志》1999年第3期206-211,共6页The Chinese Journal of Clinical Pharmacology

摘　　要：钙拮抗剂已被广泛地用于治疗心绞痛和高血压等心血管疾病。但它的严重药物不良反应，在近１０年的大规模临床试验中，也逐渐被人们所认识，尤其是短效双氢吡啶类钙拮抗剂。长效制剂无此药物不良反应。本文就目前钙拮抗剂大剂量长期使用增加死亡率，致心肌缺血，诱发出血，血压过低，负性肌力作用和诱发心律失常等，及钙拮抗剂对缺血心肌的保护作用进行讨论，认为它不具有细胞保护作用，而是通过改变血流动力学，对缺血心肌的改善起一定作用；还认为其药物不良反应与剂量呈正相关。Calcium antagonists have been among the most widely used drugs for the treatment of angina pectoris and hypertension. However, their serious side effects, particularly those caused by short_acting dihydropyridine, are gradually recognized in many of the large_scale clinical trials during the past 10 years. The side effects of calcium antagonists such as the increased mortality rate after long_term use, proischemic effects, prohemorrhagic effects, negative inotrophic effects, marked hypotension and proarrhythmic effects, are reviewed in this article. The relationship between calcium antagonists and cytoprotection of the ischemic heart tissue is also discussed, and calcium antagonists are thought to be without cytoprotection, and ameliorate to some extent the circulation of ischemic heart tissue through changing the hemodynamics; the side effects are in positive relation with the dosage. This review provides theoretical analysis for the pharmacology and clinical use of calcium antagonists.

关 键 词：钙拮抗剂 二氢吡啶类 副作用 剂量 

分 类 号：R972[医药卫生—药品]