Robertson R M, Bernard Y, Robertson D
Am Heart J. 1983 Jun;105(6):901-6. doi: 10.1016/0002-8703(83)90387-3.
We studied plasma catecholamine levels in 10 patients with frequent spontaneous episodes of coronary artery spasm to evaluate the role of the sympathetic nervous system. Peripheral venous norepinephrine in supine and upright postures, urinary excretion of catecholamines, and functional testing of the sympathetic nervous system did not differ from the same measurements in control subjects. Arterial and coronary sinus levels of norepinephrine and epinephrine drawn early in ischemia were not elevated over baseline; coronary sinus norepinephrine levels were higher than those in arterial samples and rose from 315 +/- 32 (pg/ml +/- SE) at the onset of ST elevation to 490 +/- 49 pg/ml late in ischemia (p less than 0.05). Plasma epinephrine levels, higher in arterial than coronary sinus samples, also rose significantly only late in ischemia, from 44 +/- 14 pg/ml to 148 +/- 35 pg/ml (p less than 0.05) in arterial blood and from 33 +/- 10 pg/ml to 108 +/- 29 pg/ml in coronary sinus samples (p less than 0.05). Generalized sympathetic nervous system activation is not likely to be the sole cause of coronary artery spasm.
我们研究了10例频发冠状动脉痉挛自发发作患者的血浆儿茶酚胺水平，以评估交感神经系统的作用。仰卧位和直立位时的外周静脉去甲肾上腺素、儿茶酚胺的尿排泄以及交感神经系统的功能测试与对照组的相同测量结果并无差异。缺血早期采集的动脉和冠状窦去甲肾上腺素及肾上腺素水平并未高于基线水平；冠状窦去甲肾上腺素水平高于动脉样本，且从ST段抬高开始时的315±32（pg/ml±标准误）升至缺血后期的490±49 pg/ml（p<0.05）。血浆肾上腺素水平在动脉样本中高于冠状窦样本，也仅在缺血后期显著升高，动脉血中从44±14 pg/ml升至148±35 pg/ml（p<0.05），冠状窦样本中从33±10 pg/ml升至108±29 pg/ml（p<0.05）。交感神经系统的全身性激活不太可能是冠状动脉痉挛的唯一原因。
