硝酸甘油联合阿司匹林治疗心绞痛研究

目的：研究血管扩张剂硝酸甘油联合阿司匹林治疗心绞痛的临床疗效。方法：选择我院2007年2月～2010年3月收治的90例心绞痛患者,随机分为两组,硝酸甘油联合阿司匹林治疗组（A组）45例和硝酸甘油治疗组（B组）45例,两组均给予硝酸甘油和复方丹参注射液或红花注射液静脉滴注。A组在B组的基础上加用阿司匹林,观察药物的治疗疗效和治疗前后心绞痛发作次数、血压、心率变化;并测定用药前后血糖、血脂、心肌酶的改善情况。结果：药物治疗后,A组总有效率为95.56%（43/45）,B组总有效率为84.44%（38/45）,两组差异有统计学意义（χ2=4.38,P〈0.05）;两组治疗后心电图进行比较,A组心电图有效率为97.78%（44/45）,B组为82.22%（37/45）,两组差异有统计学意义（χ2=8.25,P〈0.05）;63例（A组23例,B组40例）患者在服用硝酸甘油后出现头昏、头胀痛、低血压等症状,减少药物剂量后反应消失,未出现严重的副作用。结论：血管扩张剂联合治疗心绞痛能减缓耐药性发生,提高治愈率,值得在临床广泛应用。     

硝化甘油对男工精液质量及男工妻子妊娠结局的影响

本文报道了硝化甘油对男工精液质量及男工妻子妊娠结局的影响。结果表明：硝化甘油作业工人精液总量，精子存活率有降低趋势，精子活力明显降低，精子畸形率明显升高，与对照组相比有显著性差异（Ｐ〈０．０５），男工妻子自然流产率显著高于对照组（Ｐ〈０．０５），并出现一例死亡。     

硝酸甘油对冠心病伴青光眼患者眼内压的影响

目的 :探讨硝酸甘油对冠心病伴青光眼患者眼压的影响。方法 :4 5例冠心病伴青光眼患者均以硝酸甘油舌下含化 ,观察其含药前 ,含药后 3、5、10、30min眼压变化。结果 :含药后 4次测眼压均较含药前均有所下降 ,且用药后 5、10min眼压下降明显 ,与治疗前比较 ,差异有显著性意义 (P <0 .0 5 )。结论 :冠心病伴青光眼患者使用硝酸甘油不会引起眼压升高     

硝酸甘油贴片的药效学研究

硝酸甘油系目前防治心绞痛的常用药,由于肝脏首过效应,常须舌下给药,药效不过10～30min,长效硝酸酯类如硝酸异山梨醇酯和硝酸戊四醇酯等需大剂量口服,维持药效仅3～4h,效果未臻满意。为了延长药效,有报道制成硝酸甘油软膏及透皮释放膜剂     

脑垂体后叶素联合硝酸甘油治疗肺结核咯血临床观察

目的观察脑垂体后叶素联合硝酸甘油治疗肺结核咯血的疗效。方法44例患者随机分为两组:对照组(26例)予脑垂体后叶素及常规内科综合用药。治疗组(18例)在对照组基础上联用硝酸甘油(5mg/d)静脉滴注,疗程5~7天。结果治疗组和对照组止血率分别为83.3%和80.7%,治疗组略高于对照组,但无统计学差异(P>0.05)。治疗组不良反应发生率为10.1%,而对照组为42.4%,两组间有显著性差异(P<0.01)。结论脑垂体后叶素联合硝酸甘油能改善止血率,且不良反应大大降低,是治疗肺结核咯血的有效联合。     

静脉硝酸酯对冠状动脉支架术后胸痛和微梗死的影响

目的 :在冠状动脉支架术后静脉滴注硝酸酯 ,观察其对术后胸痛和微梗死的影响。方法 :以行经皮冠状动脉腔内成形术及支架置入术的心绞痛 (稳定型、不稳定型 )患者 5 6例为入选对象 ,术后随机分为硝酸酯组(A组 ,2 8例 )和非硝酸酯组 (B组 ,2 8例 )。比较两组临床一般特征、冠状动脉病变、置入支架数及术后两组胸痛和微梗死的发生率。结果 :两组在临床一般特征方面、冠状动脉病变、置入支架数差异无显著性意义 (P >0 .0 5 ) ,硝酸酯对术后胸痛的发生率无影响 (A组 2 5 .0 % ,B组 2 8.6 % ,P >0 .0 5 ) ,但可显著减少术后微梗死的发生率 (A组 3.6 % ,B组 2 5 .0 % ,P <0 .0 1)。结论 :选择性支架术后静脉滴注硝酸酯可安全、有效地减少因支架术后并发冠状动脉微栓塞、分支闭塞等引起的微梗死 ,而对术后胸痛的发生无明显影响。     

Activation of CB2 receptors as a potential therapeutic target for migraine: evaluation in an animal model

Background

Experimental animal models of migraine have suggested the existence of interactions between the endocannabinoid system and pain mediation in migraine. Extensive evidence has demonstrated a role for the cannabinoid-1 (CB1) receptor in antinociception. However, recent research suggests that also CB2 receptors, especially located outside the central nervous system, play a role in the perception of pain. Systemic administration of nitroglycerin (NTG) consistently induces spontaneous-like headache attacks in migraneurs; in the rat, systemic NTG induces a condition of hyperalgesia, probably through the activation of cerebral/spinal structures involved in nociceptive transmission. In this study we evaluated the role of CB2 receptors in two animal models of pain that may be relevant for migraine: the tail flick test and the formalin test performed during NTG-induced hyperalgesia.

Methods

The study was performed in male Sprague-Dawley rats pre-treated with NTG (10 mg/kg, i.p.) or vehicle (4 hours before) and treated with the CB2 agonist AM1241 o dimethylsulfoxide (DMSO) 60 minutes before both the tail flick test and the formalin test.

Results

AM1241 showed a significant analgesic effect in baseline conditions in both tests. Furthermore, when administered 3 hours after NTG administration, AM1241 at both doses significantly reduced the total number of flinches/shakes during phase II of the test.

Conclusion

These findings suggest that the pharmacological manipulation of the CB₂ receptor may represent a potential therapeutic tool for the treatment of migraine.     

A study to determine the nitroglycerin ointment dose and dosing interval that best promote the healing of chronic anal fissures

PURPOSE: The aim of this study was to determine the optimal dose and dosing interval of nitroglycerin ointment to heal chronic anal fissures. METHOD: A randomized, double-blind study of intra-anally applied nitroglycerin ointment (Anogesic) was conducted in 17 centers in 304 patients with chronic anal fissures. The patients were randomly assigned to one of eight treatment regimens (0.0, 0.1, 0.2, 0.4 percent nitroglycerin ointment applied twice or three times per day), for up to eight weeks. A dose-measuring device standardized the delivery of 374 mg ointment. Healing of fissures (complete reepithelialization) was assessed by physical examination using an observer unaware of treatment allocation. The subjects assessed pain intensity daily by completing a diary containing a visual analog scale for average pain intensity for the day, the worst pain intensity for the day, and pain intensity at the last defecation. RESULTS: There were no significant differences in fissure healing among any of the treatment groups; all groups, including placebo had a healing rate of approximately 50 percent. This rate of placebo response was inexplicably higher than previously reported in the literature. Treatment with 0.4 percent (1.5 mg) nitroglycerin ointment was associated with a significant (P < 0.0002) decrease in average pain intensity compared with vehicle as assessed by patients with a visual analog scale. The decreases were observed by Day 4 of treatment. At 8 weeks the magnitude of the difference between 0.4 percent nitroglycerin and control was a 21 percent reduction in average pain. Treatment was well tolerated, with only 3.29 percent of patients discontinuing treatment because of headache. Headaches were the primary adverse event and were dose related. CONCLUSION: Nitroglycerin ointment did not alter healing but significantly and rapidly reduced the pain associated with chronic anal fissures.