Hoshio A, Takami T, Fujimoto Y, Yamasaki J, Hasegawa J, Kotake H, Mashiba H
First Department of Internal Medicine, University of Tottori School of Medicine, Yonago.
J Cardiol. 1988 Dec;18(4):989-96.
Angiographic changes caused by administering ergonovine maleate (EM) and nitrates were quantitated in 136 patients without significant coronary artery disease. Percent coronary artery (CA) narrowing was calculated in 67 patients with a negative EM test (Group A) and 69 patients with a positive EM test (Group B) as follows: (Formula; see text) In both groups, coronary artery narrowing before and after EM did not differ among the proximal, middle or distal segments of each coronary artery. The measurements of the right coronary artery were greater than those of the left anterior descending artery (p less than 0.01 after EM, p less than 0.05 before EM), and those of the left main trunk were markedly less than those of the other coronary arteries (p less than 0.01). In both groups, coronary narrowing after EM administration was greater than before administration (p less than 0.01). Initial coronary narrowing in Group B was also greater than in Group A (p less than 0.01), similar to the responses for EM. In 19 patients with coronary artery spasm provoked by EM coronary artery narrowing before and after EM was 37 +/- 12% and 69 +/- 23% for coronary arteries with spasm, and 30 +/- 13% and 42 +/- 16% for those without spasm. Not only after, but also before EM administration, coronary narrowing was greater in the arteries with spasm than in those without spasm (p less than 0.01). Furthermore, the arteries without spasm showed greater sensitivity to EM and nitrates than did the arteries of the control patients.(ABSTRACT TRUNCATED AT 250 WORDS)
在136例无明显冠状动脉疾病的患者中，对使用马来酸麦角新碱（EM）和硝酸盐引起的血管造影变化进行了定量分析。计算了67例EM试验阴性患者（A组）和69例EM试验阳性患者（B组）的冠状动脉（CA）狭窄百分比，如下所示：（公式；见正文）在两组中，每条冠状动脉的近端、中段或远端节段在使用EM前后的冠状动脉狭窄情况无差异。右冠状动脉的测量值大于左前降支（使用EM后p<0.01，使用EM前p<0.05），左主干的测量值明显小于其他冠状动脉（p<0.01）。在两组中，使用EM后冠状动脉狭窄程度均大于使用前（p<0.01）。B组的初始冠状动脉狭窄程度也大于A组（p<0.01），与EM的反应相似。在19例由EM诱发冠状动脉痉挛的患者中，有痉挛的冠状动脉在使用EM前后的狭窄程度分别为37±12%和69±23%，无痉挛的冠状动脉分别为30±13%和42±16%。不仅在使用EM后，而且在使用EM前，有痉挛的动脉的冠状动脉狭窄程度都大于无痉挛的动脉（p<0.01）。此外，无痉挛的动脉对EM和硝酸盐的敏感性高于对照患者的动脉。（摘要截断于250字）
