Sheps D S, Hinderliter A, Bragdon E E, Adams K F, Herbst M C, Koch G
Cardiology Division, University of North Carolina School of Medicine, Chapel Hill 27514.
Am J Cardiol. 1988 Apr 21;61(12):3F-8F. doi: 10.1016/0002-9149(88)90045-8.
Evidence suggests that endogenous opioids, particularly the beta-endorphins and met-enkephalins, are closely involved in stress-induced analgesia and nociceptive pain control. Numerous investigations have been conducted to evaluate the role of opioids in silent vs symptomatic myocardial disease. There is good evidence to suggest that patients with asymptomatic ischemia have defective pain perception compared with those with angina; however, the precise role of the endorphin and enkephalin systems in this phenomenon remains to be elucidated. Possible sources for disparate study results include variation in patient populations, insensitive or improperly timed assay techniques, and differences in amount of ischemia.
有证据表明，内源性阿片类物质，尤其是β-内啡肽和甲硫氨酸脑啡肽，与应激诱导的镇痛和伤害性疼痛控制密切相关。已经进行了大量研究来评估阿片类物质在无症状性与症状性心肌病中的作用。有充分证据表明，与心绞痛患者相比，无症状性缺血患者的疼痛感知存在缺陷；然而，内啡肽和脑啡肽系统在这一现象中的确切作用仍有待阐明。不同研究结果的可能原因包括患者群体的差异、检测技术不敏感或检测时间不当，以及缺血程度的差异。
