Hoshio A, Shirota K, Sawada Y, Doi T, Miyakoda H, Kotake H, Mashiba H
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Eur Heart J. 1992 Jun;13(6):853-5. doi: 10.1093/oxfordjournals.eurheartj.a060270.
In a 58-year-old man with vasospastic angina, we investigated the relationship between the antianginal effects of isosorbide dinitrate (ISDN) and plasma ISDN concentration. Despite adequate plasma ISDN levels, sustained therapy using ISDN tapes and oral ISDN (transcutaneously 160 mg and orally 100 mg ISDN day-1) failed to exhibit antianginal effects. However, pulse therapy using sublingual short-acting ISDN prevented anginal episodes, although the plasma ISDN levels were less than those of sustained therapy. Nitrate tolerance of the antianginal effects was avoided by creating an abrupt plasma ISDN concentration gradient using sublingual ISDN.
在一名患有血管痉挛性心绞痛的58岁男性中，我们研究了硝酸异山梨酯（ISDN）的抗心绞痛作用与血浆ISDN浓度之间的关系。尽管血浆ISDN水平充足，但使用ISDN贴膜和口服ISDN（经皮给药160 mg，口服给药100 mg ISDN/天）的持续治疗未能显示出抗心绞痛作用。然而，使用舌下短效ISDN的脉冲疗法可预防心绞痛发作，尽管血浆ISDN水平低于持续治疗时的水平。通过使用舌下ISDN产生突然的血浆ISDN浓度梯度，可避免抗心绞痛作用的硝酸盐耐受性。
