Cowan J C, Bourke J P, Reid D S, Julian D G
Am J Cardiol. 1987 Aug 1;60(4):271-5. doi: 10.1016/0002-9149(87)90226-8.
This investigation assesses the extent of tolerance development with nitroglycerin patches and whether tolerance might be prevented by overnight patch removal. On commencing therapy, active patches significantly prolonged exercise time (3.5 hours after patch application) in comparison with placebo, with an accompanying reduction in ST-segment depression at maximal common workload. Patients then received continuous or 12-hour-daily intermittent patch therapy, in a double-blind fashion, for 7 days. Exercise testing was repeated before and after active patch application, on the eighth day of each treatment phase. During continuous therapy, beneficial effects on exercise time and ST depression were abolished. By contrast, during intermittent therapy, prolongation of exercise time and reduction in ST-segment depression still occurred, on testing 3.5 hours after active patch application. These results confirm previous studies showing a high degree of tolerance during continuous therapy with nitroglycerin patches and suggest that tolerance can be prevented by 12-hour-daily intermittent therapy.
本研究评估了硝酸甘油贴片耐受性发展的程度，以及通过夜间去除贴片是否可以预防耐受性。开始治疗时，与安慰剂相比，活性贴片显著延长了运动时间（贴片应用后3.5小时），同时在最大常见工作量下ST段压低有所减轻。然后患者以双盲方式接受连续或每日12小时间歇性贴片治疗，为期7天。在每个治疗阶段的第八天，在活性贴片应用前后重复进行运动测试。在连续治疗期间，对运动时间和ST段压低的有益作用消失。相比之下，在间歇性治疗期间，在活性贴片应用后3.5小时进行测试时，运动时间延长和ST段压低仍会出现。这些结果证实了先前的研究，即在硝酸甘油贴片连续治疗期间存在高度耐受性，并表明每日12小时间歇性治疗可以预防耐受性。
