非甾体抗炎药诱发的血管痉挛性心绞痛
Vasospastic angina induced by nonsteroidal anti-inflammatory drugs.
作者信息
Mori E, Ikeda H, Ueno T, Kai H, Haramaki N, Hashino T, Ichiki K, Katoh A, Eguchi H, Ueyama T, Imaizumi T
机构信息
Third Department of Internal Medicine, Kurume University School of Medicine, Japan.
出版信息
Clin Cardiol. 1997 Jul;20(7):656-8. doi: 10.1002/clc.4960200713.
Abstract
We report two cases of vasospastic angina associated with anaphylactic reaction caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Both patients exhibited anaphylactic manifestations, such as general rash and urticaria, along with angina pectoris with electrocardiographic ST-segment elevations after suppository administration of diclofenac sodium or indomethacin, the most commonly used NSAIDs. Although these patients had normal coronary arteriograms, intracoronary administration of ergonovine or acetylcholine provoked diffuse coronary artery spasms accompanied by chest pain and ischemic ST-segment changes. It is therefore suggested that an allergic mechanism may be involved as a causative factor of the coronary artery spasm induced by NSAIDs.
摘要
我们报告了两例由非甾体抗炎药（NSAIDs）引起的与过敏反应相关的血管痉挛性心绞痛病例。两名患者在直肠给药双氯芬酸钠或吲哚美辛（最常用的NSAIDs）后，均出现过敏表现，如全身皮疹和荨麻疹，同时伴有心绞痛及心电图ST段抬高。尽管这些患者的冠状动脉造影正常，但冠状动脉内注射麦角新碱或乙酰胆碱会引发弥漫性冠状动脉痉挛，并伴有胸痛和缺血性ST段改变。因此，提示过敏机制可能是NSAIDs诱发冠状动脉痉挛的一个致病因素。
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