Bellisarii F Iachini, Gallina S, Zimarino M, De Caterina R
Center of Excellence on Aging, University, Chieti, Italy.
Eur J Clin Invest. 2003 Nov;33(11):933-40. doi: 10.1046/j.1365-2362.2003.01239.x.
More than 100 years since their introduction in cardiovascular therapy, nitrates continue to be widely used in ischaemic heart disease despite incomplete knowledge of their intimate mechanism of action. Particularly, the development of a progressive attenuation of their efficacy over prolonged use (tolerance) continues to be the subject of current investigation. Newer findings point to the role of increased intracellular oxidative stress as a mechanism for tolerance and to folic acid derivatives as pharmacologic means to attenuate its development. This paper reviews nitrate mechanism of action, the history of nitrate tolerance and newer findings related to the use of folate to prevent this phenomenon.
自硝酸盐被引入心血管治疗领域已有100多年，尽管对其确切作用机制了解尚不完全，但它们仍在缺血性心脏病中广泛使用。特别是，长期使用后其疗效会逐渐减弱（耐受性），这一现象仍是当前研究的主题。最新研究结果表明，细胞内氧化应激增加是耐受性产生的一种机制，而叶酸衍生物是减轻其发展的药理学手段。本文综述了硝酸盐的作用机制、硝酸盐耐受性的历史以及与使用叶酸预防这一现象相关的最新研究结果。
