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目的探讨经肺动脉输注三磷酸腺苷（ａｄｅｎｏｓｉｎｅｔｒｉｐｈｏｓｐｈａｔｅ，ＡＴＰ）对心脏术后合并肺动脉高压患儿的肺血管扩张效应。方法对１３例确诊为室间隔缺损合并重度肺动脉高压患儿术后早期经肺动脉输入３０～１５０μｇ／ｋｇ．ｍｉｎ的ＡＴＰ，观察用药前后血流动力学参数的变化。结果与用药前相比，低剂量输入（３０～５０μｇ／ｋｇ．ｍｉｎ）ＡＴＰ，在不明显降低平均体动脉压（ＭＢＰ）的前提下，特异性的降低肺动脉压力（Ｐ＜０．０５）及肺血管阻力（ＰＶＲ）（Ｐ＜０．０１）；中－高剂量（１００～１５０μｇ／ｋｇ．ｍｉｎ）的ＡＴＰ，在明显降低平均肺动脉压（ＭＰＡＰ）（Ｐ＜０．０１）的同时，ＭＢＰ亦明显下降（Ｐ＜０．０１），ＰＶＲ与体循环阻力（ＳＶＲ）呈现相似的减低趋势。结论利用ＡＴＰ半衰期短的特点，自肺动脉直接输注ＡＴＰ，在一定剂量下可出现选择性的肺血管扩张效应
Objective To investigate the pulmonary vasodilation effect of pulmonary artery infusion of adenosine triphosphate (ATP) in children with pulmonary hypertension after cardiac surgery. Methods Thirteen patients with ventricular septal defect and severe pulmonary hypertension were treated with pulmonary arterial infusion of 30-150 μg / kg. min of ATP, observe the changes of hemodynamic parameters before and after treatment. Results Compared with pretreatment, low dose of ATP (30-50 μg / kg · min) reduced pulmonary arterial pressure (P <0.05) and decreased pulmonary artery pressure (P <0.05) Pulmonary vascular resistance (PVR) (P <0.01); moderate to high dose (100-150μg / kg.min) of ATP, significantly decreased mean pulmonary artery pressure (MPAP) Also decreased significantly (P <0.01), PVR and systemic resistance (SVR) showed a similar decreasing trend. Conclusions With the short half-life of ATP, ATP can be selectively transfused from the pulmonary artery to produce selective pulmonary vasodilator effects