Gottlieb N L, Brown H E
Arthritis Rheum. 1977 May;20(4):1026-30. doi: 10.1002/art.1780200418.
A vasomotor (nitritoid) reaction occurred following an initial injection of gold sodium thiomalate (GST; Myochrysine) in a 69-year-old man with rheumatoid arthritis (RA). An acute anterior wall myocardial infarction, documented by serial electrocardiographic and serum enzyme changes, developed immediately thereafter. A second patient, a 49-year-old man with RA and a history of GST-associated vasomotor reactions, was monitored clinically and electrocardiographically after GST administration. Sinus tachycardia developed and peripheral blood pressure fell within 2 minutes of injection, simultaneous with the onset of vasomotor symptoms. Vasomotor reactions from GST may compromise myocardial perfusion by their action on arteriolar smooth muscle, and thus result in peripheral vasodilatation, or they may act by adrenergic discharge initiated by such a reaction, and thus increase myocardial work and oxygen demand. Aurothioglucose (Solganal), rarely produces vasomotor reactions, and may be preferred to GST in elderly RA patients with concomitant cardiovascular disease or atherosclerosis.
一名69岁的类风湿关节炎（RA）男性患者在首次注射硫代苹果酸金钠（GST；金硫葡糖）后发生了血管舒缩（类亚硝酸盐样）反应。此后立即出现了急性前壁心肌梗死，连续心电图和血清酶变化证实了这一点。第二例患者是一名49岁患有RA且有GST相关血管舒缩反应病史的男性，在给予GST后进行了临床和心电图监测。注射后2分钟内出现窦性心动过速，外周血压下降，同时出现血管舒缩症状。GST引起的血管舒缩反应可能通过其对小动脉平滑肌的作用损害心肌灌注，从而导致外周血管扩张，或者它们可能通过这种反应引发的肾上腺素能释放起作用，从而增加心肌做功和氧需求。金硫葡萄糖（硫代葡萄糖金）很少引起血管舒缩反应，对于伴有心血管疾病或动脉粥样硬化的老年RA患者，可能比GST更可取。
