Reichek N
Am J Med. 1984 Jun 22;76(6A):63-6. doi: 10.1016/0002-9343(84)91045-3.
Cutaneous nitroglycerin patches offer an attractive, convenient approach to antianginal prophylaxis with nitroglycerin. Blood level data have suggested that nitroglycerin patches could have antianginal effects for 24 hours or more. However, direct documentation of antianginal efficacy is fragmentary at present. Existing studies using provocative exercise testing, with one exception, do not demonstrate antianginal effects of nitroglycerin patches at 24 hours, using either low or maximal tolerated doses in each subject. Furthermore, in contrast to other long-acting nitrates evaluated in similar fashion, the peak effects of nitroglycerin patches may not be as potent as those of sublingual nitroglycerin. Thus, at present, clinicians should not assume that nitroglycerin patches can provide 24-hour prophylaxis. Further, in patients on a patch regimen with continuing symptoms, consideration should be given to a trial of alternative or additional long-acting nitrates of other types.
皮肤用硝酸甘油贴片为硝酸甘油抗心绞痛预防提供了一种有吸引力且方便的方法。血药浓度数据表明硝酸甘油贴片可产生长达24小时或更长时间的抗心绞痛作用。然而，目前关于抗心绞痛疗效的直接证据尚不完整。现有的使用激发运动试验的研究，除一项研究外，均未显示硝酸甘油贴片在24小时时具有抗心绞痛作用，无论在每个受试者中使用低剂量还是最大耐受剂量。此外，与以类似方式评估的其他长效硝酸盐相比，硝酸甘油贴片的峰值效应可能不如舌下含服硝酸甘油的峰值效应显著。因此，目前临床医生不应假定硝酸甘油贴片能提供24小时预防作用。此外，对于采用贴片治疗方案但仍有症状的患者，应考虑试用其他类型的替代或额外长效硝酸盐。
