Nielsen F E, Nielsen S L, Knudsen F, Haedersdal C
Department of Cardiology and Clinical Physiology, Frederiksberg Hospital, Denmark.
Angiology. 1991 Aug;42(8):622-7. doi: 10.1177/000331979104200804.
An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may be due to methodologic problems. Suggestions are given for another study design to overcome these problems.
在无症状性心肌缺血的发病机制中，有人提出，由于对疼痛的感知较低，总体上抱怨疼痛的倾向较低，这与冠状动脉病变的程度和既往急性心肌梗死病史无关。在这项回顾性研究中，通过比较首次急性心肌梗死入院期间的镇痛药使用情况与出院四周后运动试验中无症状性心肌缺血的发生情况，对这一假设进行了间接检验。该研究并未显示无症状性心肌缺血患者的镇痛药使用较少，但这可能是由于方法学问题所致。文中针对克服这些问题的另一项研究设计提出了建议。
