老年稳定型心绞痛并高血压者抗心绞痛药物的联合应用  

Effects of multiple anti-angina drugs in low-dose combined on aged patients with stable angina and hypertension

作　　者：丁殿勋[1] 康建利[1] 石湘云[1] 川玲[1] 王士雯[2] 

机构地区：[1]海军总医院,北京100037 [2]解放军总医院老年心血管病研究所,北京100853

出　　处：《实用老年医学》2002年第5期252-255,共4页Practical Geriatrics

摘　　要：目的　探讨老年高血压合并稳定型心绞痛患者应用小剂量单一和多种抗心绞痛药物的短期疗效。　 方法 　 3 6例老年稳定型心绞痛合并高血压患者 (Ⅰ组 )和 3 4例稳定型心绞痛老年患者 (Ⅱ组 )口服苯磺酸氨氯地平 (络活喜 )、5 单硝异山梨醇酸酯 (德脉宁 )、倍他乐克和巯甲丙脯酸等。另 3 5例老年稳定型心绞痛患者单用德脉宁做对照组 (Ⅲ组 )。用药 2 8d后以超声心动图 (UCG)、ECG和发射型计算机断层扫描 (ECT)等评价单一和多种小剂量抗心绞痛药物的疗效。　 结果 　Ⅰ组患者心绞痛严重度降级最显著 (由 2 62级降至 1 4级 ) ,此组患者超声心动图EF % (心脏射血分数 )和ECT心肌灌注也较其余 2组有更明显提高。Ⅰ组心电图ST在服药后 3、14、2 8d与治疗前比 ,其t =2 3 4,10 94,19 0 8;前者P <0 0 5 ,后 2者均P <0 0 1,ST明显恢复。Ⅱ组也较对照组ST恢复幅度大。　 结论 　心绞痛合并高血压组老年患者在小剂量多种抗心绞痛药物合用后短期效果最好 ,表现其ST ,EF %和ECT心肌缺血和灌注均有明显恢复与提高。无高血压心绞痛组老年病人小剂量多种药物合用也较单用德脉宁疗效佳。因此对有或无高血压稳定性心绞痛老年患者应提倡小剂量多种药物联合抗心绞痛 ,则有利于治疗和防止严重心脏事件的发生。Objective To explore effects of multiple anti angina drugs in low does combined on aged patients with angina pectoris and hypertension together. Methods One hundred and five Patients(aged 60～75 years)with angina were divided into 3 groups.Aged patients with stable angina pectoris complicated with essential hypertension(group Ⅰ)or without essential hypertension(group Ⅱ) were given oral is 5 mono retard,amlodipine besylated,betaloc,etc.Another 35 patients only with stable angina(group Ⅲ) were treated with oral isosorbide mononitrate. Results After treatment,severity degrees of angina pectoris in Group Ⅰ and group Ⅱ decreased from 2 62 to 1 4 and 2 54 to 1 6,and that of group Ⅲ from 2 55 to 2 02 EF% and ECT of 3 groups were significantly improved,but they were more significant in group Ⅰ.In 3 groups decreased STs of ECG were recovered best in group Ⅰ after 3,14 and 28 days( t =2 34, P <0 05; t =10 94,19 08, P <0 01) ST recovery of group Ⅰ was less than that of other 2 groups. Conclusions The short term efficacy of group Ⅰ is best,in which ST,EF% and ECT are significantly recovered.The efficacy of group Ⅱ is better than that of group Ⅰ.So the patients with stable angina should be given low dose and multiple anti angina drugs,which is available to treat and prevent heart events.

关 键 词：高血压 心绞痛 苯磺酸氨氯地平 5-单硝异山梨醇酸酯 

分 类 号：R541.4[医药卫生—心血管疾病]