Koh H, Nambu S, Tsushima M, Nishioheda Y, Murakami K, Ikeda M
Arzneimittelforschung. 1984;34(2):185-90.
In order to clarify the effects of insulin on the cardiovascular system in patients with and without coronary heart disease (CHD), we studied the changes of electrocardiogram (ECG), blood pressure, pulse rate, along with those of blood glucose, free fatty acid, immunoreactive insulin, cortisol and potassium during insulin tolerance test (ITT). The presence or absence of CHD was verified by the coronary angiography and various stress testings beforehand. In patients with CHD, ischemic ST-T wave changes were recorded following the increment of double product after insulin injection and these changes were quite similar to those recorded during exercise test. In patients without CHD, although hypoglycemia and suppression of lipolysis were achieved, ischemic ST-T wave changes were not recorded after insulin injection. Furthermore, in a patient with Triple Vessel Disease, ischemic changes of ECG provoked by ITT were abolished completely by the administration of nifedipine and propranolol. ITT may induce ischemic changes of ECG in patients with CHD by different mechanisms from those of exercise tests and it may provide a useful tool for the diagnosis of CHD in clinical applications.
为了阐明胰岛素对冠心病（CHD）患者和非冠心病患者心血管系统的影响，我们在胰岛素耐量试验（ITT）期间研究了心电图（ECG）、血压、脉搏率以及血糖、游离脂肪酸、免疫反应性胰岛素、皮质醇和钾的变化。冠心病的有无通过冠状动脉造影和各种应激试验预先确定。在冠心病患者中，胰岛素注射后双乘积增加后记录到缺血性ST-T波改变，这些改变与运动试验期间记录的改变非常相似。在非冠心病患者中，尽管实现了低血糖和脂解抑制，但胰岛素注射后未记录到缺血性ST-T波改变。此外，在一名三支血管病变患者中，ITT诱发的心电图缺血性改变通过硝苯地平和普萘洛尔的给药完全消除。ITT可能通过与运动试验不同的机制在冠心病患者中诱发心电图缺血性改变，并且它可能为临床应用中冠心病的诊断提供一个有用的工具。
