三磷酸腺苷在病态窦房结综合征诊断中价值的探讨  

Study on the value of intravenous adenosine triphosphate as a diagnostic test for sick sinus syndrome

作　　者：张晓明[1] 邵建华[2] 王建春[2] 任宏生[2] 刘同宝[2] 朱兴雷[2] 

机构地区：[1]山东大学医学院病理生理学教研室,山东济南250012 [2]山东省立医院心内科,山东济南250021

出　　处：《山东大学学报（医学版）》2005年第6期478-480,共3页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨静脉应用三磷酸腺苷(adenosinetriphosphate,ATP)作为病态窦房结综合征(病窦)诊断方法的可行性及试验所用ATP的合适剂量。方法:将观察者分为两组:Ⅰ组(病窦组)21例;Ⅱ组(对照组,窦房结功能正常)22例。通过心电连续监测,观察所有研究对象静脉注射不同剂量ATP后窦性周期(SC)的改变情况。结果:应用ATP0.1mg/kg后,两组观察者先出现SC轻度延长及继发的SC缩短,延长的窦性周期(SCmax-BSC)及最短窦性周期(SCmin)在组间比较差异均无统计学意义(P>0.05);应用ATP0.2mg/kg后,两组观察者先出现SC延长继而出现SC缩短,Ⅰ组的SC延长较Ⅱ组显著,两组的最长窦性周期(SC-max)及SCmax-BSC比较差异均有统计学意义(P<0.01),两组的SCmin比较差异无统计学意义(P>0.05)。结论:由周围静脉快速注射ATP可用于病窦的诊断,用量在0.2mg/kg时具有诊断价值。Objective: To investigate the clinical usefulness of intravenous injection of adenosine triphosphate (ATP) for the clinical diagnosis of sick sinus syndrome(SSS)and to investigate the proper dose of ATP for this test. Methods: 43 subjects were divided into two groups: group Ⅰ(21 patients with SSS) and group Ⅱ(22 controls without sinus node dysfunction). The changes of sinus cycle length(SC) were observed after ATP 0.1mg/kg and ATP 0.2 mg/kg was injected successively. Results: All the subjects had no significant SC lengthening but had SC shortening after ATP 0.1 mg/kg injection. The SC lengthening(SCmax-BSC) had no significant difference between two groups(P>0.05). After ATP 0.2 mg/kg injection, all the subjects first had SC lengthening followed an acceleration of the sinus node activity. The longest SC (SCmax) and SCmax-BSC were much more greater in group Ⅰthan that in group Ⅱ(P<0.01). The shortest SC (SCmin) had no significant difference between two groups(P>0.05) both when used with ATP 0.1 mg/kg and 0.2 mg/kg. Conclusion: ATP test can be considered as a diagnostic method for SSS when used with ATP 0.2 mg/kg.

关 键 词：腺苷三磷酸 病窦综合征 诊断 

分 类 号：R541.74[医药卫生—心血管疾病]