冠攣縮性狭心症に対する長時間作用型Ca拮抗薬ニフェジピンCR錠の冠攣縮抑制効果

The Spasm Inhibitory Effect of Long-acting Calcium Channel Blocker,Nifedipine CR on Coronary Spastic Angina

要旨　【目的】冠攣縮性狭心症(coronary spastic angina;CSA)に対するニフェジピンCR錠の冠攣縮発作の抑制効果を検討する．【対象と方法】症候性発作を有するCSA患者10例に対しニフェジピンCR 10～40mgを1日1～2回投与し，12週間経過観察を行った．【結果】ニフェジピンCR錠投与後，即効性硝酸薬消費量は，観察期の2.9±2.8錠/週から4週後に0錠/週へ有意に減少し(p＜0.01)，全治療期を通して0錠/週であった．硝酸薬を要する胸痛発作は消失した．血圧値は有意な変動がなく正常範囲内に維持された．脈拍数は観察期(68±10bpm)に比べて治療開始4週後に有意に上昇したが(p＜0.01)，動悸，頻脈などの訴えはなかった．【結語】ニフェジピンCRは，冠攣縮性狭心症患者の即効性硝酸薬消費量を早期から有意に減少させ，発作を強力に抑制した．CSA患者の冠攣縮発作の抑制にニフェジピンCRの有用性が期待される．

　The aim of this study is to investigate the effect of nifedipine CR on coronary spastic angina(CSA).

　10CSA patients with symptomatic attacks were enrolled as test subjects and administrated 10-40mg of nifedipine CR once or twice-daily for 12 weeks.

　After this administration of nifedipine CR, consumption of short-acting nitrates are significantly decreased(at baseline:2.0±2.8 tabs/week, at week 4, 0 tabs/week, p＜0.01)continued during the treatment time. Chest pain attacks required nitrates were disappeared. Blood pressures remained within normal range. Pulse rate was significantly increased after 4 weeks(p＜0.01), but, no patients had either tachycardia or palpitations.

　These results suggested the usefulness of nifedipine CR for improvement of chest pain attacks in CSA patients.