Leisch F, Schützenberger W, Kerschner K, Hofmann R, Herbinger W
I. Medizinische Abteilung, Allgemeines Krankenhaus der Stadt Linz, Austria.
Int J Cardiol. 1988 Oct;21(1):11-9. doi: 10.1016/0167-5273(88)90004-6.
We studied the incidence of spontaneous and ergonovine-induced coronary arterial spasm during repeat coronary angiography in 96 consecutive patients with single-vessel disease who had undergone successful angioplasty. Follow-up angiography was performed after a mean of 6 months (1-8 months). Sixty patients demonstrated no restenosis and in 36 patients restenosis (greater than 50% restenosis) occurred. Spasms of the arteries at the site of dilatation were significantly (P less than 0.001) more frequent in patients with restenosis (18/36; 50%) than in patients without restenosis (4/60; 7%). Before angioplasty, no differences were found in the clinical characteristics between the two groups. Likewise, the morphologic results of angioplasty were identical. Despite long-term treatment with nifedipine (30-60 mg daily) and aspirin (0.5 g daily), 14 of 18 patients with restenosis and coronary spasm suffered from spontaneous angina, as compared to only 3 of 18 patients with restenosis without demonstrable spasm. Three of the 4 patients without restenosis but with detectable spasm were also symptomatic. Thus our findings suggest that spasm of the coronary arteries achieves some importance as a pathophysiological factor for recurrence following coronary angioplasty.
我们对96例接受成功血管成形术的单支血管病变患者在重复冠状动脉造影期间自发性和麦角新碱诱发的冠状动脉痉挛的发生率进行了研究。平均6个月（1 - 8个月）后进行随访血管造影。60例患者未显示再狭窄，36例患者发生了再狭窄（再狭窄率大于50%）。再狭窄患者（18/36；50%）扩张部位动脉痉挛的发生率显著高于（P<0.001）无再狭窄患者（4/60；7%）。血管成形术前，两组的临床特征无差异。同样，血管成形术的形态学结果相同。尽管长期服用硝苯地平（每日30 - 60毫克）和阿司匹林（每日0.5克），18例有再狭窄和冠状动脉痉挛的患者中有14例发生自发性心绞痛，而18例有再狭窄但无明显痉挛的患者中只有3例发生。4例无再狭窄但有可检测到痉挛的患者中有3例也有症状。因此，我们的研究结果表明，冠状动脉痉挛作为冠状动脉血管成形术后复发的病理生理因素具有一定重要性。
