三磷酸腺苷治疗阵发性室上性心动过速的疗效观察

目的:观察静脉注射三磷酸腺苷(adenosine triphosphate,ATP)终止阵发性室上性心动过速(paroxysmal supraventricular tachycardia,PSVT)的有效剂量和安全性,为基层医院的医生治疗PSVT推荐一种便于获取、疗效好、安全性高的治疗选择.方法:符合诊断的68例PSVT患者,常规刺激迷走神经治疗无效者,给予ATP0.10 mg/kg为起始剂量,以0.05 mg/kg为递增剂量,经肘静脉注射,直至PSVT终止或因症状较重不能忍受,单次使用最大剂量不超过0.25 mg/kg.结果:67例PSVT患者终止,所需ATP最小有效剂量为0.10mg/kg,最大剂量为0.25 mg/kg,所需ATP平均剂量为0.13 mg/kg；1例无效.患者普遍有乏力、头晕、面红、胸闷感,但均为一过性,患者能耐受,无晕厥等严重不良反应.结论:采用个体化给药,以0.15 mg/kg为起始剂量的ATP终止PSVT的有效率为82.35％,且无明显不良反应.故推荐基层医生首选ATP、采用以此剂量为起始的递增用药方法终止PSVT.

Curative effective observation on treatment of paroxysmal supraventricular tachycardia by adenosine triphosphate

Objective:To observe the effective dose and safety of intravenous injection of adenosine triphosphate(ATP) for terminating paroxysmal supraventricular tachycardia(PSVT),so as to provide the primary care physician a PSVT treatment alternative with better availability,curative effect and higher safety.Methods:68 cases of PSVT,for whom conventional stimulation on vagus nerve was useless,received intravenous bolus via elbow with an initiation dose of ATP 0.10 mg/kg and a ascending dose of 0.05 mg/kg till PSVT w...