小剂量三磷酸腺苷治疗阵发性室上性心动过速临床观察

目的观察小剂量三磷酸腺苷（ATP）治疗阵发性室上性心动过速（PSVT）的疗效及不良反应，探讨小剂量ATP治疗PSVT的价值。方法82例急诊PSVT患者，随机分成2组。小剂量ATP组45例，给予ATP0．1mg／kg快速静脉注射，随即给予20ml生理盐水快速静脉注射。普罗帕酮组37例，给予70懈普罗帕酮静脉注射。结果小剂量ATP组复律38例，普罗帕酮组复律31例，两组比较差异无统计学意义（P〉0．05），但前者复律时间明显短于后者（P〈0．01）。ATP组7例未复律者，经使用普罗帕酮复律。普罗帕酮组6例未复律者，2例经刺激迷走神经而复律，另4例经重复使用普罗帕酮而复律。ATP组不良反应发生率高于普罗帕酮组（P〈0．05），但不良反应短暂而轻微。结论小剂量ATP治疗PSVT的有效率与普罗帕酮相当，虽然不良反应发生率较高，但短暂而轻微，具有复律时间短、不影响后续抗心律失常药物使用的优点。

Clinical observation using of low dose adenosine triphosphate in treatment of paroxysmal supraventricular tachycardia

Objective To evaluate the therapy effect of low dose adenosine triphosphate （ATP） to paroxysmal supraventricular tachycardia （PSVT）, Methods Eighty two patients who were diagnosed PSVT were randomly separated into group low dose ATP （n=45）and group propafenone （n=37）. Group low dose ATP was given 0.1 mg/kg ATP and 20 ml normal saline prestently by rapid intraveneous injection. Group propafenone was given 70 mg propafenone by intraveneous injection. The achievement ratio,time of conversion,side effects of two drugs were compared. Results The achievement ratio was 84.44% in group low dose ATP and 83.78% in group propafenone （P〉0.05 ）. The time of conversion in group low dose ATP was shorter than that of group propafenone （P〈0.01）.Seven cases that did not be converted in group low dose ATP were converted by use of propafenone.Six cases did not be converted in group propafenone. Two cases were converted by stimulating vagus nerve, and four cases were converted by injecting propafenone repeatedly. More side effects were recorded in group low dose ATP （P〈0,05） ,while they were transient and mild. Conclusion Treating PSVT with low dose ATP can get a high achievement ratio simlar to propafenone. Although low dose ATF can cause more side effects than propafenone, they were transient and mild.Low dose ATP has its merits of shorter time of conversion and no effect on antiarrhythmic drugs that would be used successively.