Kattus A A, Alvaro A B, Coulson A
Chest. 1975 Jun;67(6):640-6. doi: 10.1378/chest.67.6.640.
Twenty patients with ischemic heart disease documented by coronary angiograms or ST segment depression in the ECG during treadmill walking, were administered sublingual nitroglycerin 0.3 to 0.6 mg on one occasion and a chewable form of isosorbide dinitrate 5 mg on another occasion during treadmill walking when anginal discomfort was definitely present at a mild degree of intensity. Despite continued walking at a constant speed and grade, angina was relieved in all patients, completely in most patients, partially in a few. The average time from administration of the medication to onset to relief was 74.7 seconds for nitroglycerin and 107.6 seconds for chewable isosorbide dinitrate. Average time to complete relief or maximal incomplete relief was 190.3 seconds for nitroglycerin and 315.1 seconds for chewable isosorbide dinitrate. Ischemic electrocardiographic changes were reverted toward normal by nitroglycerin in 13 subjects and by isosorbide dinitrate in 15. The differences in onset to complete relief were all statistically significant indicating that nitroglycerin is more rapid in its action than is chewable isosorbide dinitrate.
20例经冠状动脉造影或运动平板试验心电图ST段压低确诊为缺血性心脏病的患者，在运动平板试验过程中，当出现轻度强度的明确心绞痛不适时，一次舌下含服0.3至0.6毫克硝酸甘油，另一次嚼服5毫克二硝酸异山梨酯。尽管以恒定速度和坡度继续行走，但所有患者的心绞痛均得到缓解，大多数患者完全缓解，少数患者部分缓解。硝酸甘油用药至起效缓解的平均时间为74.7秒，嚼服二硝酸异山梨酯为107.6秒。硝酸甘油完全缓解或最大不完全缓解的平均时间为190.3秒，嚼服二硝酸异山梨酯为315.1秒。13例患者的缺血性心电图改变经硝酸甘油恢复正常，15例经二硝酸异山梨酯恢复正常。从起效到完全缓解的差异均具有统计学意义，表明硝酸甘油的作用比嚼服二硝酸异山梨酯更快。
