马来酸麦角新碱对冠状动脉大小的影响。

The effects of ergonovine maleate on coronary arterial size.

作者信息

Cipriano P R, Guthaner D F, Orlick A E, Ricci D R, Wexler L, Silverman J F

出版信息

Circulation. 1979 Jan;59(1):82-9. doi: 10.1161/01.cir.59.1.82.

DOI:10.1161/01.cir.59.1.82

Abstract

Changes in coronary arterial size due to ergonovine maleate are described and quantitated in 90 patients--18 with typical angina pectoris, 56 with atypical chest pain, nine with variant angina pectoris, and seven heart transplant (allograft) recipients. We observed two angiographic changes in the diameter of coronary arteries: 1) spasm, which was characterized by occlusion or marked (greater than 85%) focal or diffuse vessel narrowing, or 2) relatively mild and diffuse vessel narrowing, which was interpreted as the normal pharmacologic response to the drug. Serial bolus injections of 0.05 mg, 0.10 mg and 0.25 mg of ergonovine maleate produced diffuse narrowing of the diameter of coronary arteries of 10 +/- 1.5%, 16 +/- 1.4% and 20 +/- 1.3% (mean +/- SEM), respectively, in the 72 patients with anginal syndromes who did not develop coronary spasm. The degree of coronary arterial narrowing was the same in heart transplant recipients and in patients with normally innervated hearts who did not develop coronary spasm. We believe the normal pharmacologic response to ergonovine maleate was due to a direct vasoconstrictor action of the drug; this action was independent of neural control extrinsic to the heart.

摘要

描述并定量分析了90例患者因马来酸麦角新碱导致的冠状动脉大小变化，其中18例为典型心绞痛患者，56例为非典型胸痛患者，9例为变异型心绞痛患者，7例为心脏移植（同种异体移植）受者。我们观察到冠状动脉直径有两种血管造影变化：1）痉挛，其特征为闭塞或显著（大于85%）的局灶性或弥漫性血管狭窄；2）相对轻度的弥漫性血管狭窄，被解释为对该药物的正常药理反应。在72例未发生冠状动脉痉挛的心绞痛综合征患者中，静脉推注0.05mg、0.10mg和0.25mg马来酸麦角新碱后，冠状动脉直径分别出现了10±1.5%、16±1.4%和20±1.3%（平均值±标准误）的弥漫性狭窄。心脏移植受者和未发生冠状动脉痉挛的心脏神经支配正常的患者中，冠状动脉狭窄程度相同。我们认为，对马来酸麦角新碱的正常药理反应是由于该药物的直接血管收缩作用；这种作用独立于心脏外部的神经控制。