Petitier H, de Lajartre A Y, Geslin P, Godin J F, Victor J, Crochet D, Dupon H
Arch Mal Coeur Vaiss. 1978 Sep;71(9):1053-9.
It is currently considered as exceptional for there to be arterial pathology other than atheroma in Prinzmetal angina. The authors have found five cases of coronary fibrous dysplasia in the literature. They add a case, in a woman, of intimal fibrous dysplasia diffusely involving the three main coronary vessels. Coronary arteriography showed that spasm of the right coronary artery was the cause of attacks with the clinical and electrocardiographic features of Prinzmetal angina. The whole coronary tree was otherwise normal angiographically and also macroscopically at autopsy. The dysplasia was only discovered by histological study of serial sections of the three coronary vessels. Histological examination showed no evidence of an atheromatous lesion. The authors place these coronary artery lesions within the general classification of arterial fibrous dysplasias. It remains hypothetical whether there is a relationship between the occurrence of spasm and this very special histological feature of the coronary artery wall.
目前认为，除动脉粥样硬化外，普林兹金属型心绞痛出现其他动脉病变的情况极为罕见。作者在文献中发现了5例冠状动脉纤维发育异常的病例。他们补充了1例女性病例，其内膜纤维发育异常广泛累及三条主要冠状动脉。冠状动脉造影显示，右冠状动脉痉挛是导致具有普林兹金属型心绞痛临床和心电图特征发作的原因。冠状动脉造影显示整个冠状动脉树在其他方面正常，尸检时大体检查也正常。这种发育异常仅通过对三条冠状动脉连续切片的组织学研究才被发现。组织学检查未发现动脉粥样硬化病变的证据。作者将这些冠状动脉病变归入动脉纤维发育异常的一般分类中。痉挛的发生与冠状动脉壁这种非常特殊的组织学特征之间是否存在关联仍属推测。
