Omote S, Yasue H, Takizawa A, Nagao M, Hyon H, Nishida S, Horie M
Angiology. 1983 Aug;34(8):553-60. doi: 10.1177/000331978303400807.
We performed coronary arteriography and gave intracoronary injection of nitrates within 8 hours after the onset of symptoms of acute myocardial infarction in eighteen patients. Improved distal filling or patency of the total occluded coronary artery after intracoronary injection of nitrates occurred in 4 of 18 patients. In one of four patients the first intracoronary nitrates injection failed to release the initial total occlusion, but after intracoronary Urokinase administration, the second nitrates injection succeeded to dilate the completely occluded coronary artery. Coronary arteriography was again performed in sixteen patients in the chronic stage (4-15 weeks after the onset of acute myocardial infarction) and ergonovine maleate was injected intravenously in seven patients. Focal spasm was induced by ergonovine injection in three patients in one of whom intracoronary nitrates failed to release the complete obstruction in the acute stage. We conclude that coronary spasm as well as intracoronary thrombosis plays an important role in the production of acute myocardial infarction.
我们对18例急性心肌梗死症状发作后8小时内的患者进行了冠状动脉造影，并进行了冠状动脉内注射硝酸盐。18例患者中有4例在冠状动脉内注射硝酸盐后，远端灌注改善或完全闭塞的冠状动脉通畅。在这4例患者中的1例，首次冠状动脉内注射硝酸盐未能解除最初的完全闭塞，但在冠状动脉内给予尿激酶后，第二次注射硝酸盐成功扩张了完全闭塞的冠状动脉。16例处于慢性期（急性心肌梗死发作后4 - 15周）的患者再次进行了冠状动脉造影，7例患者静脉注射了马来酸麦角新碱。3例患者注射麦角新碱后诱发了局灶性痉挛，其中1例在急性期冠状动脉内注射硝酸盐未能解除完全阻塞。我们得出结论，冠状动脉痉挛以及冠状动脉内血栓形成在急性心肌梗死的发生中起重要作用。
