在过去几年,已经清楚地证明不论是在固定的冠状动脉硬化性疾病或X线检查正常的冠状动脉上发生的冠状动脉痉挛,是引起Prinzmetal氏变异型心绞痛的原因。最近,有些报告试图说明冠状动脉痉挛亦是典型心绞痛和心肌梗塞的诱发因素。因此,在缺血性心脏病的发病机理上,冠状动脉痉挛可能起有较以往设想更为重要的作用。由于过去几年在一些研究中得到了许多新的资料,看来有必要对冠状动脉痉挛在这些病理生理状态下的作用作一综述。在早年有关典型心绞痛的描述中,Latham和Osler提出心绞痛可能是由于大的冠状动脉发生痉挛所致。然而,病理和病理生 Over the past few years, it has been clearly demonstrated that Coronary spasm, which occurs either in fixed coronary artery disease or in normal X-rayed coronary arteries, is the cause of Prinzmetal’s variant angina. Recently, some reports attempt to show that coronary artery spasm is also a predisposing factor for typical angina and myocardial infarction. Therefore, in the pathogenesis of ischemic heart disease, coronary artery spasm may play more important than the previous idea. Given the many new data available in several studies over the past few years, it seems necessary to review the role of coronary spasm in these pathophysiological states. In his earlier account of typical angina, Latham and Osler argued that angina may be due to cramps in the large coronary arteries. However, pathology and pathology