摘要
目的 :探讨血管紧张素转换酶抑制剂 ( ACEI)对硝酸甘油 ( NTG)耐药的影响及机制。方法 :将 65例不稳定型心绞痛 ( UAP)患者分为 NTG组 ( 组 )、NTG+Captopril组 ( 组 )、NTG+非巯基 ACEI组 ( 组 ) ,观察耐药比例、收缩压 ( SBP)、血小板环磷酸鸟苷 ( c GMP)、血浆血管紧张素 ( Ang )、内皮素 ( ET)、缓激肽 ( BK)变化。结果 :1 组和 组耐药比例均较 组低 ( P <0 .0 5 ) ;2加用 Captopril和非巯基 ACEI能使 NTG滴注过程后期的 SBP回升及血小板 c GMP下降得到抑制 ;3血小板 c GMP能反映 NTG耐药 ;4ACEI能在 NTG滴注过程中使缩血管物质 ( Ang 、ET)减少、舒血管物质 ( BK)增多。结论 :在克服硝酸甘油耐药方面 ,含巯基的 Captopril与非巯基 ACEI作用类似。BK途径可能是 ACEI对抗
Objective:To investigate the effect and the mechanism of angiotensin converting enzyme inhibitors (ACEI) on nitroglycerin (NTG) to lerance.Method:65 cases of unstable angina patients were divided into three groups:NTG group (GroupⅠ),NTG plus Captopril group (Group Ⅱ),NTG plus non sulfhydryl ACEI group (Group Ⅲ).The percentage of NTG tolerance,systolic blood pressure (SBP),platelet cyclic guanosine monophosphate (cGMP),plasma angiotensin Ⅱ (Ang Ⅱ),endothelin (ET),bradykinin (BK) were investigated.Result:(1)the percentage of NTG tolerance in Group Ⅱ and Group Ⅲ were lower than that of Group Ⅰ(P< 0.05 );(2)Captopril and non sulfhydryl ACEI could inhibit the re elevation of SBP and the decrease of platelet cGMP at the later stage during the NTG infusion;(3)Platelet cGMP could be an indicator of nitrate tolerance;(4)ACEI could decrease the production of vasoconstrictor substances such as Ang Ⅱ,ET and increase the production of vasorelaxant substances such as BK.Conclusion:Captopril and non sulfhydryl ACEI exert similar effects in inhibiting NTG tolerance.BK pathway plays a key role in the effect of ACEI against NTG tolerance.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
1999年第2期57-60,共4页
Journal of Clinical Cardiology
关键词
硝酸甘油
耐药性
ACEI
Nitrate tolerance Cyclic guanosine monophosphate Endothelin Bradykinin Angiotensin converting enzyme inhibitors
