Shimizu H, Lee J D, Ogawa K, Hara A, Nakamura T
First Department of Internal Medicine, Fukui Medical School, Japan.
Intern Med. 1992 Jan;31(1):22-7. doi: 10.2169/internalmedicine.31.22.
Coronary vasoreactivity of patients with chest pain syndrome (CPS, 18 patients) was examined with intracoronary acetylcholine infusion test (ACh). For comparison, 10 patients with vasospastic angina (VSA) and 17 patients without chest pain (control group) were used. The luminal diameters of coronary arteries were measured before and after ACh, and the maximal value of constriction rate of each segment (MCR) was used as index of vasoreactivity in each patient. By the ACh test, an average MCR of 42 +/- 23% was observed in CPS, 84 +/- 17% in VSA, and 26 +/- 12% in the control group. In CPS, chest pain was induced by ACh in 7 patients (group I), but was not induced in the other 11 patients (group II). The average MCR of group I (66 +/- 18%) was significantly higher than group II (28 +/- 9%, p less than 0.01) and the control group (p less than 0.01), though lower than VSA (p less than 0.05). These findings suggest that increased coronary vasoreactivity may play an important role in the chest pain development in CPS.
采用冠状动脉内注入乙酰胆碱试验（ACh）检测胸痛综合征（CPS，18例患者）患者的冠状动脉血管反应性。作为对照，选取了10例血管痉挛性心绞痛（VSA）患者和17例无胸痛患者（对照组）。在注入ACh前后测量冠状动脉的管腔直径，将每个节段的最大收缩率（MCR）作为每位患者血管反应性的指标。通过ACh试验，观察到CPS患者的平均MCR为42±23%，VSA患者为84±17%，对照组为26±12%。在CPS患者中，7例患者（I组）经ACh诱发胸痛，而其他11例患者（II组）未诱发胸痛。I组的平均MCR（66±18%）显著高于II组（28±9%，p<0.01）和对照组（p<0.01），但低于VSA组（p<0.05）。这些发现提示冠状动脉血管反应性增加可能在CPS胸痛的发生中起重要作用。
