McGregor M, Crelinsten G L
Am J Cardiol. 1984 Jan 1;53(1):225-7. doi: 10.1016/0002-9149(84)90716-1.
Intravenous indomethacin has been reported to diminish coronary flow in patients with angina. There is also evidence that indomethacin attenuates or abolishes the coronary dilator and venodilator effects of nitroglycerin. In 11 patients with stable angina of effort, prior administration of 100 mg of indomethacin appeared to increase (0.10 greater than p greater than 0.05), rather than reduce, the work load achieved compared with placebo on a double-blind basis. The increase in work load when patients were given nitroglycerin was not significantly changed after they were given indomethacin. Therefore, this study does not support the suggestion either that prostaglandins play a significant role in coronary vasoregulation on effort or that prostacyclin is an important mediator of the therapeutic action of nitroglycerin. From a practical therapeutic viewpoint, there is apparently no danger of aggravating stable, exercise-induced angina or of abolishing the benefit normally expected from nitroglycerin when patients with angina are given indomethacin in doses comparable to those used in this study.
据报道，静脉注射吲哚美辛会减少心绞痛患者的冠状动脉血流量。也有证据表明，吲哚美辛会减弱或消除硝酸甘油的冠状动脉扩张和静脉扩张作用。在11例稳定劳力型心绞痛患者中，与安慰剂进行双盲对照时，预先给予100mg吲哚美辛似乎会增加（P大于0.05且小于0.10）而非降低所达到的工作量。给予患者硝酸甘油后增加的工作量，在给予吲哚美辛后并无显著变化。因此，本研究不支持以下观点：即前列腺素在劳力时的冠状动脉血管调节中起重要作用，或者前列环素是硝酸甘油治疗作用的重要介质。从实际治疗角度来看，当给心绞痛患者使用与本研究中相当剂量的吲哚美辛时，显然不存在加重稳定的运动诱发型心绞痛或消除通常预期的硝酸甘油益处的风险。
