CAJ | 학술논문

目的探讨三磷酸腺苷(ATP)诱发房室结双径路(DAVNP)现象的有效剂量及安全性.方法 40例慢-快型房室结折返性心动过速(AVNRT)患者经导管射频消融(RFCA)前经股静脉快速(2 s内)注射ATP(0.15 mg/kg起始量,每次增加0.10 mg/kg),直至出现DAVNP现象、第二度或第三度房室传导阻滞(AVB)等.连续记录体表心电图和心腔内心电图.结果 40例慢-快型AVNRT患者静脉注射A11P(16.1±5.8)mg(9～22 mg)后,出现不同程度的AVB,具有DAVNP现象者29例(72.5%,29/40)其中11例(37.9%,11/29)静脉注射ATP 0.15 mg/kg后显示DAVNP现象.17例患者出现短暂的胸闷、头昏、咳嗽、心悸和呼吸困难等症状,多在用药后15～20 s发生,3～7 s后消失.40例患者均出现一过性心律失常.结论运用小剂量递增法诱发DAVNP现象的阳性率较高.ATP的不良反应较多,但一般较轻微,持续时间较短,不引起严重后果.
목적 탐토삼린산선감(ATP)유발방실결쌍경로(DAVNP)현상적유효제량급안전성.방법 40례만-쾌형방실결절반성심동과속(AVNRT)환자경도관사빈소융(RFCA)전경고정맥쾌속(2 s내)주사ATP(0.15 mg/kg기시량,매차증가0.10 mg/kg),직지출현DAVNP현상、제이도혹제삼도방실전도조체(AVB)등.련속기록체표심전도화심강내심전도.결과 40례만-쾌형AVNRT환자정맥주사A11P(16.1±5.8)mg(9～22 mg)후,출현불동정도적AVB,구유DAVNP현상자29례(72.5%,29/40)기중11례(37.9%,11/29)정맥주사ATP 0.15 mg/kg후현시DAVNP현상.17례환자출현단잠적흉민、두혼、해수、심계화호흡곤난등증상,다재용약후15～20 s발생,3～7 s후소실.40례환자균출현일과성심률실상.결론 운용소제량체증법유발DAVNP현상적양성솔교고.ATP적불량반응교다,단일반교경미,지속시간교단,불인기엄중후과.
Objective To investigate the effective dose and safety of adenosine triphosphate(ATP) in inducing dual atrioventricular nodal pathways(DAVNP)phenomenon.Methods The ATP(the initial dose was 0.15 mg/kg,incremented 0.10 mg/kg each time)was injected to 40 patients who had slow-fast atrioventricular nodal reentrant tachycardia(AVNRT)through a femoral vein until signs of DAVNP,second-or third-degrec atrioventricular block(AVB)appared.The surface and intracardiac electrocardiogram was recorded consecutively.Results Forty patients of the slow-fast AVNRT had AVB after injecting ATP (16.1±5.8)mg(9-22 mg),29 patients(72.5%,29/40)occurred DAVNP phenomenon,of which 11 (37.9%,11/29)revealed DAVNP phenomenon after injecting ATP 0.15 mg/kg.Seventeen patients had side-effects of dyspnea,dizziness,cough,cardiopalmus and so on,but these side-effects were generally minor,short duration.Forty patients had transient cardiac arrhythmia.Conclusions The incremental low-dose method in inducing DAVNP has higher positive rate.The side-effects of ATP are mostly light and short duration,and can not cause serious consequence.