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薬物負荷による冠攣縮の診断 : アセチルコリンとエルゴノビンの差異および高度瀰漫性冠収縮の意義に注目して
http://hdl.handle.net/10191/42952
http://hdl.handle.net/10191/429521b72fdc2-0d2b-45c8-b503-ab709f4a231f
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
110(3)_100-115.pdf (4.0 MB)
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| Item type | 紀要論文 / Departmental Bulletin Paper(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2016-08-02 | |||||
| タイトル | ||||||
| タイトル | 薬物負荷による冠攣縮の診断 : アセチルコリンとエルゴノビンの差異および高度瀰漫性冠収縮の意義に注目して | |||||
| タイトル | ||||||
| タイトル | 薬物負荷による冠攣縮の診断 : アセチルコリンとエルゴノビンの差異および高度瀰漫性冠収縮の意義に注目して | |||||
| 言語 | en | |||||
| 言語 | ||||||
| 言語 | jpn | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | coronary spasm | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | variant angina | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | acetylcholine | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | ergonovine | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | coronary constriction | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 冠攣縮 | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 異型狭心症 | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | アセチルコリン | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | エルゴノビン | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 冠血管収縮 | |||||
| 資源タイプ | ||||||
| 資源 | http://purl.org/coar/resource_type/c_6501 | |||||
| タイプ | departmental bulletin paper | |||||
| その他のタイトル | ||||||
| その他のタイトル | Diagnosis of Coronary Artery Spasm by Drugs : With Special Concern in the Differences Between Acetylcholine and Ergonovine, and the Significance of Diffuse Severe Coronary Constriction | |||||
| 著者 |
田村, 雄助
× 田村, 雄助 |
|||||
| 著者別名 | ||||||
| 識別子Scheme | WEKO | |||||
| 識別子 | 114047 | |||||
| 姓名 | Tamura, Yusuke | |||||
| 抄録 | ||||||
| 内容記述タイプ | Abstract | |||||
| 内容記述 | The purpose of this study was to clarify the appropriate methods and diagnostic criteria for coronary artery spasm provocative tests. Acetylcholine (Ach) was administered into 302 coronary arteries (the left coronary artery was counted as one) of 168 patients (pts) and ergonovine maleate (EM) into 433 arteries of 247 pts. A coronary constriction with a flow of TIMI (Thrombolysis in Myocardial Infarction) grade 0 to 2, and a diffuse severe constriction with a TIMI-3 flow that accompanies ischemic ECG changes were considered positive. Among pts with documented variant angina, Ach was positive in 27 (90%) of 30 pts evaluated, while EM was positive in 33 (97.1%) of 34. EM was positive in the 3 pts in whom Ach was negative. By the artery-based analysis, Ach was positive in 28 (63.6%) of 44 arteries and EM in 40 (74.1%) of 55. In angina at rest, Ach was positive in 22 (52.4%) of 42 pts and EM in 31 (51.7%) of 60 pts. In atypical chest pain Ach was positive in 6 (15.4%) of 39 pts (8 of 79 arteries), but EM in only one of 61 pts (one of 124 arteries). In pts with other clinical diagnoses, Ach was positive in 17 (30.1%) of 55 pts and in 23 (23.2%) of 99 arteries and EM in 16 (20.5%) of 78 pts and in 17 (11.7%) of 145 arteries (difference statistically significant by the artery-based analysis). Diffuse severe coronary constriction was induced by Ach in 13 arteries of 11 pts and by EM in 6 arteries of 5 pts. In atypical chest pain, 7 arteries of 5 pts showed diffuse severe constriction by Ach but none by EM. In variant angina no artery showed diffuse constriction with Ach and two with EM. However, the catheter had wedged into the coronary ostium in these two. When the 263 arteries of 151 pts that received both agents were analyzed, the results were similar. In these pts, 46 arteries were positive to both Ach and EM, 25 to only Ach and 11 only to EM. In variant angina 18 arteries were positive to both, 6 were positive to EM alone and 2 to Ach alone. in pts other than variant angina, by contrast, the number of arteries that was positive to Ach alone was larger than that of arteries positive to EM alone. The differences still existed even if diffuse severe constriction was not considered positive. These results suggest that EM is more appropriate than Ach as a spasm inducing agent, and that a diffuse severe constriction with a TIMI-3 flow, which is more often induced by Ach, should not be considered to be a positive response. | |||||
| 書誌情報 |
新潟医学会雑誌 en : 新潟医学会雑誌 巻 110, 号 3, p. 100-115, 発行日 1996-03 |
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| 出版者 | ||||||
| 出版者 | 新潟医学会 | |||||
| ISSN | ||||||
| 収録物識別子タイプ | ISSN | |||||
| 収録物識別子 | 00290440 | |||||
| 書誌レコードID | ||||||
| 収録物識別子タイプ | NCID | |||||
| 収録物識別子 | AN00182415 | |||||
| 著者版フラグ | ||||||
| 値 | publisher | |||||
