Martsevich S Iu, Kutishenko N P, Metelitsa V I
Ter Arkh. 1995;67(6):8-10.
The effect of abrupt discontinuation of nifedipine (N) on exercise tolerance and myocardial ischemia was studied in 7 patients with stable angina pectoris of effort (AP). N was administered in a dose of 20 mg 4 times a day for 34 days. Exercise treadmill tests were performed before N therapy in placebo treatment, on N treatment day 1, 28, on the first day after abrupt N discontinuation and 8 days after the latter. Upon acute and regular administration N produced a significant improvement in exercise tolerance before the onset of AP, development of moderate AP and up to 1 mm depression of ST-segment. Abrupt N discontinuation resulted in substantial deterioration in exercise performance pronounced more definitely on hour 21 and 24 after the last dose intake. A substantial increase in the sum of ST-segment depression at the onset of AP and at the development of AP of moderate severity occurred on the first day of N withdrawal. 8 days after N cessation all the exercise parameters returned to the baseline levels. We conclude that abrupt cessation of regular N therapy may cause a withdrawal syndrome which manifested with a decrease in the exercise tolerance and an increase in exercise-induced myocardial ischemia.
研究了7例劳力性稳定型心绞痛（AP）患者突然停用硝苯地平（N）对运动耐量和心肌缺血的影响。N以每日4次、每次20mg的剂量给药，持续34天。在安慰剂治疗时、N治疗第1天、第28天、突然停用N后的第1天以及之后8天进行运动平板试验。急性和常规给药时，N在AP发作前、中度AP发展时以及ST段压低达1mm之前能显著改善运动耐量。突然停用N导致运动表现大幅恶化，在最后一次服药后21小时和24小时更为明显。在停用N的第一天，AP发作时和中度严重程度AP发展时ST段压低总和大幅增加。停用N 8天后，所有运动参数均恢复至基线水平。我们得出结论，突然停止常规N治疗可能会引起戒断综合征，表现为运动耐量下降和运动诱发的心肌缺血增加。
