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目的:观察贝那普利与地尔硫卓对心脏X综合征患者的疗效。方法:心脏X综合征患者45例接受贝那普利(22例,贝那普利组)或地尔硫卓(23例,地尔硫卓组)治疗,治疗3个月后随访临床情况并复查平板运动试验、冠状动脉血流储备(CFR)及血浆一氧化氮(NO)、血浆内皮素-1(ET-1)的含量。结果:用药3个月后贝那普利组和地尔硫卓组胸痛例数及最大ST段压低幅度明显减少(分别为P<0.01,P<0.05),ET-1水平明显下降(均P<0.01),血浆CFR及NO的水平明显升高(P<0.01或P<0.05),运动总时间、ST段压低1 mm时间明显延长(P<0.01或P<0.05)。与地尔硫卓组相比贝那普利组胸痛例数及最大ST段压低幅度减少更显著(均P<0.05),ET-1水平下降更显著(P<0.01),CFR及NO的水平升高更显著(均P<0.05),运动总时间、ST段压低1 mm时间延长更显著(分别为P<0.01,P<0.05)。结论:贝那普利与地尔硫卓均能改善心脏X综合征患者的内皮细胞功能提高患者的运动耐量及CFR,且与地尔硫卓相比贝那普利更为有效。
Objective: To observe the efficacy of benazepril and diltiazem in patients with cardiac X syndrome. METHODS: Forty-five patients with cardiac syndrome X were treated with benazepril (22 in the benazepril group) or diltiazem (23 in the diltiazem group). After 3 months of treatment, follow-up was followed up and treadmill exercise tests were performed. Coronary Arterial blood flow reserve (CFR) and plasma nitric oxide (NO), plasma endothelin-1 (ET-1) levels. Results: After 3 months of treatment, the number of chest pain and the maximum ST depression in benazepril group and diltiazem group were significantly decreased (P <0.01, P <0.05, respectively) and ET-1 levels were significantly decreased (P <0.01 or P <0.05). The total exercise time and ST segment depressing 1 mm significantly prolonged (P <0.01 or P <0.05). Compared with diltiazem group, the number of chest pain and the maximal ST segment depression in benazepril group decreased more significantly (all P <0.05), the ET-1 level decreased more significantly (P <0.01), and the levels of CFR and NO increased (All P <0.05). The total time of exercise and ST segment depressing 1 mm were more prolonged (P <0.01 and P <0.05, respectively). CONCLUSIONS: Both benazepril and diltiazem improve endothelial function in patients with cardiac X syndrome and improve exercise tolerance and CFR, and are more effective than diltiazem compared with diltiazem.