Toman J, Lupinek Z, Janousek S, Nechvatal L, Zeman K
Faculty of Medicine, J.E. Pukyne University, Brno, Czechoslovakia.
Cardiology. 1991;79 Suppl 2:58-62. doi: 10.1159/000174926.
Transdermal nitroglycerin patches are used mainly in the therapy of angina pectoris. However, the magnitude and duration of their effects are still controversial. In this study, transdermal discs with nitroglycerin were given to 14 patients with acute myocardial infarction (AMI) and mild hemodynamic impairment. Seven patients received Nitroderm TTS, and seven patients Deponit 5 (in this case 2 patches), the nitroglycerin dose being 10 mg. Hemodynamic measurements were made 19-24 h after application of the patch and 1 h after its removal. Comparing with the values obtained 1 h after removal of the patch, 19-24 h after the application of the patch heart rate was significantly higher (90.2 +/- 3.8 vs. 85.6 +/- 4.0 min-1; p less than 0.01), mean right atrial pressure was significantly lower (10.8 +/- 1.0 vs. 12.7 +/- 1.3 mm Hg; p less than 0.01), and so were the pulmonary artery pressure: systolic (36.9 +/- 3.0 vs. 43.0 +/- 3.1 mm Hg; p less than 0.001), mean (26.8 +/- 2.1 vs. 31.4 +/- 2.0 mm Hg; p less than 0.001) and the capillary wedge pressure (19.2 +/- 1.8 vs. 23.0 +/- 1.9 mm Hg; p less than 0.01). These findings revealed that in patients with AMI hemodynamic effects persist for at least 19 h after single application of a nitroglycerin patch of 10 mg. The therapy is safe and the risk of side effects is small.
经皮硝酸甘油贴片主要用于心绞痛的治疗。然而，其效果的程度和持续时间仍存在争议。在本研究中，将含硝酸甘油的透皮贴剂给予14例急性心肌梗死（AMI）且有轻度血流动力学损害的患者。7例患者接受硝酸甘油透皮贴剂（Nitroderm TTS），7例患者接受德波尼特5（Deponit 5，在此情况下为2片），硝酸甘油剂量为10 mg。在贴剂应用后19 - 24小时及去除后1小时进行血流动力学测量。与去除贴剂1小时后获得的值相比，贴剂应用后19 - 24小时心率显著升高（90.2±3.8对85.6±4.0次/分钟；p<0.01），平均右心房压力显著降低（10.8±1.0对12.7±1.3 mmHg；p<0.01），肺动脉压力也是如此：收缩压（36.9±3.0对43.0±3.1 mmHg；p<0.001）、平均压（26.8±2.1对31.4±2.0 mmHg；p<0.001）和毛细血管楔压（19.2±1.8对23.0±1.9 mmHg；p<0.01）。这些发现表明，在AMI患者中，单次应用10 mg硝酸甘油贴剂后血流动力学效应至少持续19小时。该治疗是安全的，副作用风险较小。
