硝酸酯类药物具有扩张冠状动脉和外周动静脉的作用,能够有效改善心肌缺血,缓解心绞痛症状,减轻心脏负荷,被广泛应用于心血管疾病的治疗。但长期使用硝酸酯类药物可产生耐药性,导致抗心绞痛等临床疗效减弱。目前,评价硝酸酯耐药方法的研究很多,主要有观察抗心绞痛作用、踏车运动试验、测量外周动脉扩张程度、前臂体积描记法、测量血浆中一些因子水平的变化、直接测量冠状动脉血管的扩张程度等方法在临床上得到应用。各种方法均有其优缺点,在临床工作中应根据实际情况,多方面多手段个体化评估硝酸酯类耐药性,从而得到最大临床收益。

Nitrates have the effects of dilating coronary artery and peripheral and vein, and can effectively improve myocardial ischemia, relieve angina pectoris, and reduce cardiac load. Therefore, nitrates are widely used in treatment of cardiovascular diseases. But the long-term use of nitrates may cause resistance and weaken the effect of anti-angina pectoris. At present, there are many methods evaluating the nitrate tolerance, such as observing anti-anginal effects, bicycle ergometer test, measuring the dilation of peripheral artery, forearm plethysmography, measuring the changes of some factor levels in plasma, and directly measuring the dilation of coronary artery blood vessel used in clinic. These methods have their own advantages and disadvantages. More aspects and methods should be taken in evaluating the resistance of nitrates individually to make the maximal clinical benefit.