Lambert C R, Pepine C J
Cardiovasc Clin. 1989;20(1):131-40.
From the studies and observations reviewed in this chapter, it can be appreciated that there is considerable direct and circumstantial evidence to implicate coronary artery spasm as a primary phenomenon in some patients with myocardial infarction. Although currently available data indicate that the number of acute myocardial infarctions due primarily to "pure" coronary artery spasm is relatively small, it should be emphasized that essentially very little if any data exist at "time zero" or at the actual onset of infarction. Most myocardial infarctions are probably multifactorial in etiology. To what extent coronary artery spasm, atherosclerosis, platelets, in situ thrombosis, endothelial mediators, and passive influences on vascular caliber interact in the pathogenesis of acute myocardial infarction remains incompletely understood.
从本章回顾的研究和观察中可以看出，有大量直接和间接证据表明冠状动脉痉挛是一些心肌梗死患者的主要发病机制。虽然目前可得的数据表明，主要由“单纯”冠状动脉痉挛导致的急性心肌梗死病例数量相对较少，但应强调的是，在“零时”或梗死实际发作时，几乎没有相关数据。大多数心肌梗死的病因可能是多因素的。冠状动脉痉挛、动脉粥样硬化、血小板、原位血栓形成、内皮介质以及血管口径的被动影响在急性心肌梗死发病机制中的相互作用程度仍未完全明了。
