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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 ,故推荐采用以此剂量为起始的递增用药方法终止心动过速
Objective To evaluate the efficacy and safety of adenosine triphosphate (ATP) in 46 patients with paroxysmal supraventricular tachycardia (PSVT) who were diagnosed as having paroxysmal supraventricular tachycardia (PSVT). Methods Tachycardia was induced by esophageal pacing or intracardiac electrophysiology. To the elbow vein as the site of administration, 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 can not stand. Results The minimum effective dose of ATP required to terminate tachycardia in this group was 0.050 mg · kg-1 and the maximum dose was 0.220 mg · kg-1. The average dose of ATP needed to terminate all tachycardia was 0 .118mg · kg-1, 95% confidence interval [0. 0 35, 0.220]. The termination of the process of mild chest pressure, fatigue, dizziness and other symptoms, no syncope occurred in all patients. Conclusions The individualized medication method, the effective rate of termination of PSVT with ATP starting from 0 .15 0 mg · kg-1 is 82.6%, with good effect and no obvious side effects, so it is recommended to use this dose as The initial incremental medication stops tachycardia