Sueda S, Mineoi K, Kondo T, Yano K, Ochi T, Ochi N, Kukita H, Kawada H, Matsuda S, Uraoka T
Department of Cardiology, Takanoko Hospital, Ehime.
J Cardiol. 1998 Aug;32(2):83-8.
The differences in clinical characteristics were studied between variant angina pectoris with ST segment elevation during ischemic attacks and non-variant angina pectoris without ST segment elevation. Spasm provocation test was performed with either acetylcholine or ergonovine in 192 consecutive patients with vasospastic angina from January 1991 to June 1997. Thirteen patients were excluded because of insufficient data. Fifty-five patients had variant angina and 124 patients had non-variant angina. Coronary risk factors, serum cholesterol level, triglyceride level, high-density lipoprotein cholesterol level, history of syncope, the rates of second or third atrioventricular block and ventricular tachycardia or fibrillation, the incidence of organic stenosis (> or = 50%), the number of vessels with provoked spasm, the dose of acetylcholine and ergonovine used, and duration from the first appearance of chest pain were compared between the 2 groups. Patients with variant angina had more fixed stenosis (p < 0.01), required more percutaneous transluminal coronary angioplasty procedures, lower doses of intracoronary administration of acetylcholine for the induction of coronary arterial spasm and shorter duration from the first appearance of chest pains (p < 0.01) than patients with non-variant angina. However, there were no differences in other factors between the 2 groups. Variant angina pectoris has the same clinical characteristics as non-variant angina pectoris, although variant angina tends to cause higher spasmophilic activity and more fixed stenosis.
对缺血发作时伴有ST段抬高的变异型心绞痛与不伴有ST段抬高的非变异型心绞痛的临床特征差异进行了研究。在1991年1月至1997年6月期间，对192例连续性血管痉挛性心绞痛患者进行了乙酰胆碱或麦角新碱激发试验。13例患者因数据不足被排除。55例患者为变异型心绞痛，124例患者为非变异型心绞痛。比较了两组患者的冠状动脉危险因素、血清胆固醇水平、甘油三酯水平、高密度脂蛋白胆固醇水平、晕厥史、二度或三度房室传导阻滞及室性心动过速或颤动的发生率、器质性狭窄（≥50%）的发生率、激发痉挛的血管数量、所用乙酰胆碱和麦角新碱的剂量以及胸痛首次出现后的持续时间。与非变异型心绞痛患者相比，变异型心绞痛患者有更多的固定狭窄（p<0.01），需要更多的经皮腔内冠状动脉成形术，诱导冠状动脉痉挛所需的冠状动脉内注射乙酰胆碱剂量更低，胸痛首次出现后的持续时间更短（p<0.01）。然而，两组患者在其他因素方面没有差异。变异型心绞痛与非变异型心绞痛具有相同的临床特征，尽管变异型心绞痛往往导致更高的痉挛倾向活性和更多的固定狭窄。
