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在Prinzmeatal的变异性心绞痛中,冠状动脉痉挛起着重要作用,许多报告推荐采用硝酸酯类和/或钙拮抗剂治疗。因为冠状血管的收缩是通过交感神经a受体兴奋而引起的。α受体阻滞剂如苄胺唑啉或苯苄胺可以缓解这种现象。本文报告应用选择性α_1受体阻滞剂哌唑嗪(prazosin)治疗6例顽固性变异性心绞痛。全部患者表现为心绞痛发作后,暂时性的S-T段抬高,其中3例已经从变异性心绞痛演变为心肌梗塞。所有患者均应用过大剂量硝苯吡啶、异搏定、硝酸酯类及β阻滞剂等,均无明显效果。6例患者分别给予口服哌唑嗪,起始量为3～4mg/d,逐渐增加至症状缓解,最大剂量30mg/d。所有病人合并服用小剂量的消心痛(30～40mg/d)或硝苯吡啶(40mg/d)。
Coronary spasm plays an important role in Prinzmeatal’s variant angina and many reports recommend the use of nitrates and / or calcium antagonists. Because coronary vasoconstriction is caused by sympathetic nerve a receptor excitement. Alpha blockers such as benzylazoline or benbenzamide can alleviate this phenomenon. This article reports the use of prazosin, a selective alpha-1 blocker, in the treatment of 6 refractory variant angina pectoris. All patients presented with transient S-T elevation after angina pectoris, of which 3 had evolved from variant angina to myocardial infarction. All patients have used large doses of nifedipine, verapamil, nitrates and beta blockers, etc., no significant effect. 6 patients were given oral prazosin, the initial amount of 3 ~ 4mg / d, gradually increased to relieve symptoms, the maximum dose of 30mg / d. All patients were treated with small doses of resolving heartburn (30 ~ 40mg / d) or nifedipine (40mg / d).