弹丸注射三磷腺苷对冠状动脉血流的影响

Effect of adenosine triphosphate injected as a bolus on coronary flow

目的 研究静脉弹丸注射三磷腺苷 (ATP)对冠状动脉血流的影响和临床意义。方法 38例高血压病和心电图心肌缺血者接受经食管多普勒超声检查 ,测定和比较静脉弹丸注射 2 0 m g三磷腺苷与静脉缓慢注射 0 .84 m g/ kg潘生丁后的冠状动脉血流速度和血流储备 (CFR) ;结果 注射 ATP后冠状动脉舒张期峰值和平均血流速度分别为 (114 .0± 4 2 .9) cm/ s和 (84 .6± 33.4 ) cm / s ,CFR分别为 2 .7± 0 .8和 2 .6± 0 .8,略大于注射潘生丁后的相应值(111.3± 37.7) cm/ s和 (83.0± 32 .6 ) cm/ s及 2 .6± 0 .7和 2 .5± 0 .7,无显著差异 ,上述相应测值之间呈高度和中高度相关 (r=0 .919,0 .90 4 ,0 .5 99和 0 .6 0 0 ) ,静脉弹丸注射 ATP测定 CFR仅需 3min,而静脉缓慢注射潘生丁测定CFR需 13m in。结论 冠状动脉血流储备测定中静脉弹丸注射 ATP临床应用价值优于潘生丁。

Objective To evaluate the effect of adenosine triphosphate injected as a bolus intravenously on coronary flow and its clinical significance. Methods 38 patients with hypertension or myocardial ischemia on electrocardiogram were evaluated by transesophageal Doppler echocardiography. The values of coronary flow velocity and flow reserve (CFR) after adenosine triphosphate (20mg ) injected as a bolus and persantin (0.84mg/kg) injected intravenously and slowly were measured and compared. Results After injecting ATP, the coronary diastolic peak and mean flow velocity were 114.0±42.9 (cm/s) and 84.6±33.4 (cm/s) and CFR were 2.7±0.8 and 2.6±0.8, respectively, slight but nonsignificant higher than that after injecting persantin, 111.3±37.7 (cm/s) , 83.0± 32.6(cm/s), 2.6±0.7 and 2.5±0.7, respectively. There were high and higher correlation between above corresponding values (r=0.919, 0.904, 0.599 and 0.600). The time for measuring CFR was 3 minutes during ATP injected as bolus and 13 minutes during persantin injected intravenously. Conclusion The clinical significance of ATP injected as bolus overmatch that of persantin.