静脉注射三磷酸腺苷终止阵发性室上性心动过速有效剂量的探讨  

A study of the effective dosage of intravenous ATP terminating paroxysmal supraventricular tachycardia

作　　者：任凤学[1] 郭继鸿[1] 许原[1] 李学斌[1] 金华[1] 刘肆仁[1] 孙凤群[2] 

机构地区：[1]北京大学人民医院心内科,100044 [2]承德医学院附属医院

出　　处：《中华心律失常学杂志》2000年第3期184-187,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　对符合诊断的 46例具有阵发性室上性心动过速 (paroxysm al supraventriculartachycardia,PSVT)的患者 ,经周围静脉注射三磷酸腺苷 (adenosine triphosphate,ATP) ,探讨其终止心动过速的有效剂量。　方法　通过食管起搏或心内电生理检查的方法诱发心动过速。以肘静脉为给药部位 ,以 0 .0 5 0 mg· kg- 1为起始剂量 ,以 0 .0 2 5 m g· kg- 1为递增量 ,用药剂量直至 PSVT终止或因症状较重而不能忍受。　结果　终止本组心动过速所需 ATP最小有效剂量为 0 .0 5 0 mg· kg- 1 ,最大剂量为0 .2 0 0 mg· kg- 1 ,终止全部心动过速所需 ATP剂量平均为 0 .118mg· kg- 1 ,95 %的可信区间为[0 .0 35 ,0 .2 0 2 ]。终止过程有轻度的胸部压迫感、乏力、头晕等症状 ,所有患者均无晕厥发生。　结论　采用个体化的用药方法 ,以 0 .15 0 mg· kg- 1为起始剂量的 ATP终止 PSVT的有效率为 82 .6 % ,效果好且没有明显的副作用 。Objective To study the minimal effective dosage of intravenous ATP required to terminate paroxysmal supraventricular tachycardia. Methods Fourtysix patients with supraventricular tachycardia were involved in this group.PSVT was induced by transesophageal atrial pacing or intra cardiac pacing.ATP was administered intravenously.The initial dose of ATP was 0 050 mg·kg -1 ,and an increment dose of 0 025 mg·kg -1 was followed successively if the previous injection was ineffective until the arrhythmia was terminated or the patient intolerance occurred. Results The minimal effective dosage of ATP terminating PSVT was 0 050 mg·kg -1 ,The maximum effective dosage was 0 200 mg·kg -1 ,The average dosage of ATP terminating supraventricular tachycardia was 0 118 mg·kg -1 with the 95% confidence interval [0 035,0 202].Most patients complained of chest compression,fatigue.adverse effects such as syncopal attack was not observed. Conclusion For the purpose of terminating PSVT,the ATP dosage given should be individualized.An initial dose of 0 150 mg·kg -1 is recommended.An effective rate of 82 6% could be obtained with no serious adverse effects.

关 键 词：三磷酸腺苷 剂量 阵发性室上性心动过速 

分 类 号：R96[医药卫生—药理学]