The intracoronary drug provocation test has been the gold standard for diagnosis of coronary artery spasm (CAS); however, it has been identified with severe complications. In this study, we investigated the sensitivity, specificity, and safety of radial artery provocation test at different doses of ergonovine in the diagnosis of CAS. This study enrolled 57 patients, which were then divided into CAS group (n = 24) and control group (n = 33) after intracoronary ergonovine provocation test. All patients underwent radial artery provocation test at different doses of ergonovine. The predictive values of radial artery provocation test for the diagnosis of CAS were analyzed using receiver operator characteristic curve. In the radial artery provocation test at different doses of ergonovine, radial artery stenosis degree was all found to be significantly higher in the CAS group than in the control group (all P < 0.001). In the control group, significant differences were noted in the radial artery stenosis degree between different doses of ergonovine (all P < 0.05). In the CAS group, the radial artery stenosis degree was significantly higher in 160 μg and 100 μg of ergonovine than in 60 μg of ergonovine (all P < 0.001). The radial artery provocation test at 60 μg and 100 μg of ergonovine did not cause CAS, chest pain, and ECG ischemic changes. In the radial artery provocation test at 160 μg of ergonovine, some patients had CAS, chest pain, and ECG ischemic changes. The specificity and sensitivity of radial artery provocation test were 90.91% and 50.00% at 60 μg of ergonovine, 96.97% and 66.67% at 100 μg of ergonovine, and 90.91% and 95.83% at 160 μg of ergonovine for the diagnosis of CAS. As per our findings, we can conclude that the basic tension of radial artery increases in the CAS group. With the increase of ergonovine doses, its sensitivity and specificity improve, but its safety decreases. We will explore the most optimal dose of ergonovine in future studies.

冠脉内药物激发试验已成为诊断冠状动脉痉挛（CAS）的金标准；然而，它已被确定为具有严重的并发症。在本研究中，我们研究了不同剂量麦角新碱的桡动脉激发试验在诊断 CAS 中的敏感性、特异性和安全性。本研究共纳入57例患者，分为CAS组（n = 24）和对照组（n= 33) 冠状动脉内麦角新碱激发试验后。所有患者均接受不同剂量麦角新碱的桡动脉激发试验。采用受试者工作特征曲线分析桡动脉激发试验对CAS诊断的预测价值。在不同剂量麦角新碱的桡动脉激发试验中，CAS组桡动脉狭窄程度均显着高于对照组（均P < 0.001）。在对照组中，不同剂量麦角新碱的桡动脉狭窄程度存在显着差异（均P < 0.05）。CAS 组中，160 μg 和 100 μg 麦角新碱的桡动脉狭窄程度显着高于 60 μg 麦角新碱（所有P< 0.001)。60 μg 和 100 μg 麦角新碱的桡动脉激发试验未引起 CAS、胸痛和心电图缺血性改变。在 160 μg 麦角新碱的桡动脉激发试验中，一些患者出现 CAS、胸痛和心电图缺血性改变。桡动脉激发试验的特异性和敏感性分别为60 μg麦角新碱90.91%和50.00%，100 μg麦角新碱96.97%和66.67%，诊断麦角新碱CAS的90.91%和95.83%。根据我们的研究结果，我们可以得出结论，CAS 组桡动脉的基本张力增加。随着麦角新碱剂量的增加，其敏感性和特异性提高，但安全性降低。我们将在未来的研究中探索麦角新碱的最佳剂量。