Chauhan A, Mullins P A, Gill R, Taylor G, Petch M C, Schofield P M
Regional Cardiac Unit, Papworth Hospital, Cambridge, UK.
Postgrad Med J. 1996 Feb;72(844):99-104. doi: 10.1136/pgmj.72.844.99.
The relative prevalence of abnormalities of coronary flow reserve and oesophageal function was ascertained in 32 syndrome X patients with typical angina chest pain, a positive exercise test, and normal coronary arteries. Coronary flow reserve in response to a hyperaemic dose of papaverine was measured using an intracoronary Doppler catheter positioned in the left anterior descending coronary artery. An abnormal coronary flow reserve was defined as being < 3.0. Patients were investigated for oesophageal dysfunction by manometry and 24-hour pH monitoring. Thirteen patients had an impaired coronary flow reserve (group 1) and 19 patients had a normal flow reserve (group 2). Eight of the 13 group 1 patients (62%) and 13 of the 19 group 2 patients (68%, p = NS) had evidence of oesophageal dysfunction on either manometry or pH studies. Therefore, a total of 26 (81%) syndrome X patients had either an abnormality of coronary flow reserve or oesophageal dysfunction suggesting that chest pain in these patients may be due to myocardial ischaemia or oesophageal dysfunction, thus confirming the heterogeneous nature of this syndrome. The prevalence of oesophageal abnormalities was independent of any abnormalities of coronary flow reserve.
在32例患有典型心绞痛性胸痛、运动试验阳性且冠状动脉正常的X综合征患者中，确定了冠状动脉血流储备异常和食管功能异常的相对患病率。使用置于左前降支冠状动脉的冠状动脉内多普勒导管，测量对罂粟碱充血剂量的冠状动脉血流储备。冠状动脉血流储备异常定义为<3.0。通过测压和24小时pH监测对患者进行食管功能障碍检查。13例患者冠状动脉血流储备受损（第1组），19例患者血流储备正常（第2组）。第1组的13例患者中有8例（62%），第2组的19例患者中有13例（68%，p=无显著性差异）在测压或pH研究中有食管功能障碍的证据。因此，共有26例（81%）X综合征患者存在冠状动脉血流储备异常或食管功能障碍，提示这些患者的胸痛可能是由于心肌缺血或食管功能障碍，从而证实了该综合征的异质性。食管异常的患病率与冠状动脉血流储备的任何异常无关。
