Ueda O, Okazaki H, Kohchi K, Koga N, Hiraoka M
Department of Cardiology, Chiba Tokushukai Hospital.
Kokyu To Junkan. 1991 Jul;39(7):673-7.
Coronary spasm is an important etiologic mechanism in the pathogenesis of myocardial ischemia. Provocative test of coronary spasm during coronary arteriography is clinically useful. The ergonovine test has gained widespread use, and we have examined the efficacy and safety of intracoronary ergonovine application with a fixed dose of 16 micrograms. We studied 119 patients undergoing coronary arteriography. Coronary spasm was induced in 34 cases by intracoronary administration of 16 micrograms of ergonovine maleate. Coronary spasm was readily resolved by intracoronary administration of isosorbide dinitrate. None of the cases negative to the intracoronary ergonovine applications could be induced by additional systemic administration of 0.4 mg of ergonovine. Side effects of ergonovine such as elevation of blood pressure, headache and chest symptoms were infrequent in the intracoronary ergonovine test. We conclude that our method of intracoronary ergonovine application is sensitive and safe for the diagnosis of coronary spasm.
冠状动脉痉挛是心肌缺血发病机制中的一个重要病因机制。冠状动脉造影时冠状动脉痉挛激发试验具有临床应用价值。麦角新碱试验已得到广泛应用，我们已研究了冠状动脉内应用固定剂量16微克麦角新碱的有效性和安全性。我们研究了119例行冠状动脉造影的患者。通过冠状动脉内给予16微克马来酸麦角新碱，在34例患者中诱发了冠状动脉痉挛。冠状动脉内给予硝酸异山梨酯后冠状动脉痉挛迅速缓解。冠状动脉内麦角新碱试验阴性的病例，额外静脉给予0.4毫克麦角新碱均不能诱发痉挛。冠状动脉内麦角新碱试验中，麦角新碱的副作用如血压升高、头痛和胸部症状并不常见。我们得出结论，我们的冠状动脉内麦角新碱应用方法对冠状动脉痉挛的诊断敏感且安全。
