Sievert H, Selzer G, Schneider W, Kober G, Kaltenbach M, Bussmann W D
Department of Cardiology, University Hospital Frankfurt, F.R.G.
Eur Heart J. 1989 Nov;10 Suppl F:134-6. doi: 10.1093/eurheartj/10.suppl_f.134.
In a randomized double-blind study, 40 patients with coronary heart disease received either 0.025 mg nitroglycerin or placebo intravenously. Before and 2-3 min after injection, the aortic and left ventricular pressures were recorded and coronary angiography was performed. Mean heart rate, systolic and diastolic aortic pressure, left ventricular filling pressure and the pre- and poststenotic coronary artery diameters, as well as the diameters of representative distal coronary artery segments showed no significant changes. Coronary artery stenosis diameters remained unchanged after placebo (1.01 +/- 0.5 to 1.13 +/- 0.49 mm; n.s.) but increased significantly after nitroglycerin from 1.15 +/- 0.68 to 1.32 +/- 0.73 mm (P less than 0.01). Since it has been demonstrated, on the other hand, that the same dose of nitroglycerin reveals antianginal activity, it can be hypothesized from these results that dilatation of coronary stenoses plays an important role in the antianginal action of nitroglycerin. Strong haemodynamic effects do not appear to be a prerequisite of the beneficial effects of nitroglycerin.
在一项随机双盲研究中，40例冠心病患者静脉注射0.025毫克硝酸甘油或安慰剂。注射前及注射后2 - 3分钟，记录主动脉和左心室压力并进行冠状动脉造影。平均心率、主动脉收缩压和舒张压、左心室充盈压以及狭窄前后冠状动脉直径，以及代表性远端冠状动脉节段的直径均无显著变化。安慰剂注射后冠状动脉狭窄直径无变化（1.01±0.5至1.13±0.49毫米；无统计学意义），但硝酸甘油注射后显著增加，从1.15±0.68毫米增至1.32±0.73毫米（P<0.01）。另一方面，由于已证明相同剂量的硝酸甘油具有抗心绞痛活性，从这些结果可以推测，冠状动脉狭窄的扩张在硝酸甘油的抗心绞痛作用中起重要作用。强烈的血流动力学效应似乎不是硝酸甘油有益作用的先决条件。
