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目的:观察钾通道阻滞剂格列本脲对冠心病伴糖尿病患者发生Warm-up现象的影响。方法:选择47例运动试验阳性和经冠状动脉造影证实,至少单支冠状动脉狭窄程度为70%～90%的慢性稳定型心绞痛伴糖尿病患者作为研究对象。根据其血糖控制方式分为格列本脲治疗组(治疗组,22例)与节食对照组(对照组,25例),通过间隔15min的连续运动试验来观察2组2次运动中心电图上反映缺血情况的指标变化。结果:治疗组2次运动相比除ST段压低0.1mV出现的时间有所后延外,余指标均未见明显缺血减轻的改变(P>0.05);对照组则在第2次运动后发生了明显的Warm-up效应(P<0.05)。缺血阈值和极量运动时的ST段压低最大值在第2次运动后的改善情况2组间比较,差异有统计学意义(P<0.05)。结论:以节食方式控制血糖良好的稳定型心绞痛并发糖尿病患者可以发生Warm-up现象,格列本脲能阻断Warm-up现象的发生。
Objective: To observe the effects of potassium channel blocker glibenclamide on Warm-up in patients with coronary heart disease and diabetes mellitus. Methods: Forty-seven patients with positive chronic exercise test and confirmed by coronary angiography were selected as the study subjects. Patients with at least one coronary artery stenosis of 70% to 90% with chronic stable angina pectoris and diabetes mellitus were enrolled. According to their glycemic control, they were divided into two groups: the treatment group (n = 22) and the diet control group (n = 25) Changes in indicators of ischemic conditions. Results: Compared with the control group, no significant change of ischemia was observed in the two groups of exercise except the time when the ST segment depression was 0.1mV (P> 0.05); while in the control group, after the second exercise Significant Warm-up effect occurred (P <0.05). There was significant difference between the two groups in the threshold of ischemic stroke and the maximum value of ST segment depression during the second exercise (P <0.05). Conclusion: Warm-up may occur in patients with stable angina and diabetes with dieting. Glibenclamide can block Warm-up phenomenon.