硝酸酯类药物的耐药性及影响因素与对策

Resistance to the Action of Nitrate Drug and the Impacting Factors and Countermeasures

使用硝酸酯类药物常可产生耐药性 ,耐药性的产生与长期使用、加大药物的剂量有关。其机制可能是 ,细胞巯基耗竭 ,使鸟苷酸环化酶活性降低 ,致血管平滑肌松弛作用减弱。此外 ,神经体液系统被激活 ,血容量增加 ,超氧阴离子增加 ,也起着一定的作用。防治措施主要采用间歇疗法 ,补充巯基供体 (如乙酰半胱氨酸、蛋氨酸 ) 。

It is common that using nitrate drugs leads to resistance to their action. The cause of the resistance is related to long term employment and increase of dosage. The mechanism is probably that the consumption of cell mercapto lowers the activity of guanylate cyclase, thus weakening the slackness of blood vessel's smooth muscles. In addition, the nerve body fluid system's being activated, the increase of blood capacity and the super oxide negative ions can also play certain roles. The prevention and cure measures include: adopting indirect therapy, replenishing mercapto donors (eg. Acetylcysteine and methionine ), employing anti oxidant.