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有许多证明近端冠状动脉痉挛是可以发生的。这种现象的发病率尚不清楚,但失去原状稳定的环境(指体内环境,如为了证实痉挛而作的心导管操作)是有影响的。现在当有下面的情况时,推测冠状动脉痉挛为引起临床症状的原因是合理的。(1)临床证明,强烈的表示冠状动脉血流有暂时的降低并伴有 S-T 段升高,而无心肌氧的需要增加时;2在典型的胸痛发作期间,冠状动脉造影和心电图变化,在冠状动脉循环的一个区域里表示了可逆性的痉挛,心电图的记录可作为预测的手段。硝酸盐在可逆性冠状动脉痉挛中的效用,表示应当避免在冠状动脉造影之先对怀疑有痉挛的任何人立即应用预防性硝酸盐。同样的,在冠状动脉口操作导管的影响,表明在可疑冠状动脉痉挛的病例中,可借未加选择的冠状动脉造影,试图得到最初最好的冠状动脉的形象。因为近端冠状动脉生理学和病理生理学尚未清楚的了解,进一步详细地研究控制近端冠状动脉的口径的机理是必要的,除非一直到这些研究解决了上述问题,否则冠状动脉痉挛的治疗会仍停止在按照经验去处理,并在很大程度上是试验性质的和错误的。
There is much evidence that proximal coronary artery spasms can occur. The incidence of this phenomenon is not yet known, but the loss of an otherwise stable environment (referring to the internal environment, such as cardiac catheterization in order to confirm convulsions) is affected. Now when the following circumstances, speculated that coronary artery spasm is the cause of clinical symptoms caused is reasonable. (1) Clinical evidence strongly suggests that there is a temporary reduction in coronary blood flow accompanied by an increase in ST segment without a need for increased myocardial oxygen; 2 coronary angiography and electrocardiographic changes during a typical chest pain episode Reversible spasms are indicated in one area of the coronary circulation, and electrocardiographic recording can be used as a predictive measure. The utility of nitrates in reversible coronary spasm suggests that immediate use of prophylactic nitrates should be avoided for anyone suspected of cramping prior to coronary angiography. Similarly, the effect of catheterization at the coronary ostia shows that in the case of suspected coronary artery spasm, the best initial coronary arteries can be attempted by unselected coronary angiography. Because proximal coronary physiology and pathophysiology are not well understood, it is necessary to study the mechanism of controlling the diameter of the proximal coronary artery in more detail, and until these studies do not solve the above problems, the treatment of coronary artery spasm will stop Are handled according to experience and are to a large extent experimental and error.