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目的应用肱动脉血管超声及运动试验的方法对冠心病患者服硝酸酯类药后耐药性进行评价。方法根据给药的间期不同，采用随机、对照、双盲方法将６６例冠心病患者分为两组：Ａ组：硝酸异山梨醇每天４次（每６小时组）；Ｂ组：硝酸异山梨醇每天２次（每１２小时组），疗程均为１周。疗程前、后分别进行肱动脉血管超声观察血管内径对该药含服后反应及活动平板运动试验。结果疗程前Ａ组与Ｂ组硝酸异山梨醇１０ｍｇ含服后肱动脉内径均显著增加（３９０±０６６ｍｍｖｓ４４８±０８９ｍｍ和３８１±０５７ｍｍｖｓ４．３６±０７６ｍｍ），而疗程后Ｂ组肱动脉内径显著增加（４１０±０７９ｍｍｖｓ４．４５±０９１ｍｍ），Ａ组增加不明显（３９７±０８８ｍｍｖｓ４．０７±０９９ｍｍ）。两组服药后肱动脉内径比较差异有显著性。与疗程前比较，疗程后Ａ组运动诱发各导联ＳＴ段缺血型下移之和（ΣＳＴ）（８４５±２４１ｍｍｖｓ８．０８±３７２ｍｍ）及运动时间（７４５±２３３ｍｉｎｖｓ８．０１±２７８ｍｉｎ）无明显改善，而疗程后Ｂ组ΣＳＴ明显减少（９１５１±２５８ｍｍｖｓ５．３６±１６４ｍｍ）、运动时间显著性增加（７５９±２９２ｍｉｎｖ?
Objective To evaluate the drug resistance of patients with coronary heart disease by taking brachial artery ultrasound and exercise test. Methods Sixty-six patients with coronary heart disease were divided into two groups according to the different interval of administration: group A: isosorbide dinitrate 4 times a day (every 6 hours); group B: nitric acid Sorbitol 2 times a day (every 12 hours group), treatment for 1 week. Before and after the treatment, brachial artery ultrasound was performed to observe the intravascular diameter and the response to the drug and the treadmill exercise test. Results Before treatment, the diameter of brachial artery in group A and group B was significantly increased after isosorbide dinitrate 10 mg (390 ± 066mmvs448 ± 089mm and 381 ± 057mmvs4.36 ± 076mm ). After treatment, the diameter of brachial artery in group B increased significantly (410 ± 079mm vs4.45 ± 091mm), while the increase in group A was not obvious (397 ± 088mm vs4.07 ± 099mm). Two groups after taking brachial artery diameter difference was significant. Compared with pre-treatment, after exercise, the scores of ST segment ischemia (ΣST) (845 ± 241mm vs8.08 ± 372mm) and exercise time (745 ± 2) 33minvs8.01 ± 278min), while the ΣST of group B decreased significantly after treatment (9151 ± 258mm vs5.36 ± 164mm), the exercise time was significantly increased (759 ± 292minv ?