Mikuniya A, Mikami M, Fujino Y, Higashiyama A, Murayama S, Onodera K, Kikuchi F, Sawai M, Akitsu H, Oikawa M
Second Department of Internal Medicine, Hirosaki University School of Medicine.
Kokyu To Junkan. 1991 May;39(5):449-56.
We investigated changes in coronary venous oxygen saturation (CSO2-Sat) dynamics during intracoronary infusion of ergonovine (ERG) or acetylcholine (ACh) in patients with vasospastic angina. In 16 patients with suspected vasospasm in the left coronary artery, intracoronary ERG injection provoked vasospasm in 4 out of 6 patients, and intracoronary ACh in 6 out of 11 patients. A gradual decrease in CSO2-Sat, anteceding angina and ischemic ECG evidence, was characteristic in ERG-induced vasospastic patients, while no significant change of CSO2-Sat was observed in non ERG-induced patients. Intracoronary infusion of ACh was followed in all 11 patients by a transient increase in CSO2-Sat, suggesting decreased myocardial oxygen extraction due to increased coronary blood flow with ACh. However, earlier and sudden decreases in CSO2-Sat below the control levels were characteristic in 6 patients with ACh-induced vasospastic angina. These findings suggest that effects of ERG and ACh on coronary flow dynamics are essentially different although both drugs can provoke vasospasm.
我们研究了在冠状动脉内注入麦角新碱（ERG）或乙酰胆碱（ACh）期间，变异性心绞痛患者的冠状静脉血氧饱和度（CSO2-Sat）动力学变化。在16例疑似左冠状动脉痉挛的患者中，冠状动脉内注射ERG后，6例患者中有4例诱发了血管痉挛，冠状动脉内注射ACh后，11例患者中有6例诱发了血管痉挛。在ERG诱发血管痉挛的患者中，心绞痛和缺血性心电图证据出现之前，CSO2-Sat逐渐下降是其特征，而在未诱发血管痉挛的患者中，未观察到CSO2-Sat有显著变化。11例患者冠状动脉内注入ACh后，CSO2-Sat均出现短暂升高，提示ACh使冠状动脉血流增加，心肌氧摄取减少。然而，6例ACh诱发变异性心绞痛的患者，其CSO2-Sat较对照水平更早、更突然地下降是其特征。这些发现表明，尽管两种药物均可诱发血管痉挛，但ERG和ACh对冠状动脉血流动力学的影响本质上是不同的。
