硝酸酯类药物耐药机制及临床应对策略研究进展

摘要

在全球范围内，急性心肌梗死发病率、病死率均很高，硝酸酯类药物作为急性心肌梗死及心绞痛的一线治疗药物，可有效增加血管内皮细胞一氧化氮（ NO）含量及心肌血供，扩张冠状动脉，但长期持续使用可导致硝酸酯类药物耐药，进而导致其扩张血管作用减弱或消失、血管内皮细胞功能紊乱、缺血区心肌细胞存活能力降低、心肌梗死面积扩大等，因此硝酸酯类药物耐药受到越来越多学者的关注。本文就硝酸酯类药物耐药机制及临床应对策略进行综述。%Acute myocardial infarction is a kind of worldwide diseases with high morbidity and mortality, as the first-line drugs of acute myocardial infarction and angina pectoris, organic nitrates drugs can effectively increase the NO content of vascular endothelial cell and myocardial blood flow, expand coronary artery, but long-term continuous using of organic nitrates drugs may result in drug resistance, and then induce the effect decreased or disappeared for expanding blood vessel, vascular endothelial cell dysfunction, ischemic myocardial cells survival ability decreased, myocardial infarct area enlarged and so on.In recent years, more and more people pay attentions to organic nitrates drugs resistance, this paper reviewed resistance mechanisms of organic nitrates drugs and the clinical coping strategy.