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心得安已广泛用于治疗心绞痛,作者报告6例劳力后心绞痛的病人,由于突然停止心得安的治疗而发展为变异型心绞痛,其疼痛发作的特征及频率比之在心得安使用前或使用期间有严重恶化。其中4例在连续变异型心绞痛发作2～21天后,有3例发生急性心肌梗死,1例突然死亡;另2例在重新用心得安治疗后才恢复。全部病例在治疗前为中等度心绞痛,对心得安治疗反应良好。鉴于病人发生心肌梗死和死亡是在停用心得安后出现变异型心绞痛期间,说明它们之间有因果关系,作者认为病人出现前所未有的休息时及夜间心绞痛,充分说明它是对停药的反跳现象,而不是症状的复发。因而,有明显心绞痛的病人,当使用心得安症状控制后停药时,如逐渐减少其剂量,可能会使反跳现象减少到最低限度。作者指出,停用心得安所致的反跳现象在临床上并不多见,偶而可在冠状动脉造影或手术前突然停药时见到。因此,由于停用心得安而出现变异型心绞痛患者,应立即再用心得安治疗,且在此期间作冠状动脉造影或手术是不明智的。虽然,突然停止心得安后出现冠状动脉综合征者
Empriety has been widely used in the treatment of angina, the authors report six cases of labor angina patients, due to the sudden discontinuation of the treatment of anaplasia and angina pectoris, the characteristics and frequency of pain episodes than before or during use Serious deterioration. Of the 4 patients, 2 to 21 days after the onset of continuous variant angina, 3 had acute myocardial infarction and 1 died suddenly; the other 2 patients regained their consciousness after resuscitation. All cases were moderate angina before treatment and had good response to propofol. In view of the patient’s myocardial infarction and death during the withdrawal of anisotropy during the occurrence of variant angina, indicating a causal relationship between them, the author believes that patients with unprecedented rest and nocturnal angina, fully demonstrated that it is anti-drug rebound Phenomenon, not the recurrence of symptoms. Thus, patients with significant angina pectoris may be able to minimize back-bounce when their medication is discontinued following the use of propranolol. The authors note that the discontinuation of cardiac arrest caused by rebounding is clinically uncommon and occasionally seen on coronary angiography or abrupt discontinuation prior to surgery. Therefore, patients with variant angina should be rehabilitated immediately after their withdrawal from safety. In this period, coronary angiography or surgery is unwise. Although, suddenly stopped after the safety of coronary syndrome