自主神经张力的变化对三磷酸腺苷终止室上性心动过速的影响

The effect in autonomic nervous system on supraventricular tachycardia termination by adenosine triphosphate

目的 :探讨自主神经张力的变化对三磷酸腺苷 (ATP)终止室上性心动过速 (SVT)的影响。方法 :30例有心动过速病史的患者经食道心房调搏诱发 SVT后 ,随机分为 3组 ,每组 10例。 组 :诱发 SVT后 ,静脉快速推注 ATP(剂量由小到大 )终止 SVT; 组 :诱发 SVT后 ,先给予异丙基肾上腺素 (2 μg/ m in,5 m in)静脉点滴 ,再用 ATP终止 ; 组 :诱发 SVT后 ,先静脉推注阿托品 (0 .0 4m g/ kg) ,再给予不同剂量的 ATP终止 SVT,ATP的剂量依次为 :0 .15 ,0 .175 ,0 .2 ,0 .2 2 5 ,0 .2 5 ,0 .2 75 ,0 .3,0 .32 5 ,0 .35和 0 .375 mg/ kg,ATP用药间隔时间为 3m in。结果 :ATP终止 SVT的有效剂量在应用异丙肾上腺素、阿托品后都显著高于基础状态下的剂量 (P<0 .0 5 )。结论 :自主神经张力的变化对

This study is to investigate the effect of autonomic nervous system on the termination of supraventricular tachycardia (SVT) by adenosine triphosphate (ATP). Thirty patients with clinically documented SVT were divided into three groups,each consisting of 10 patients. In group Ⅰ,ATP was intravenously injected to terminate SVT during the baseline state after SVT was induced. In group Ⅱ, after SVT was induced,isoproterenol infusion (2 μg/min for 5 min) was administored before ATP was intravenously injected to terminate SVT. In group Ⅲ,after SVT was induced,atropine (0.04 mg/kg) was injected before ATP was intravenously injected to terminate SVT. The doses of ATP were 0.15,0.175,0.2,0.225,0.25,0.275,0.3,0.325,0.35 and 0.375 mg/kg respectively. The minimal doses of ATP needed to terminate SVT after isoproterenol infusion of 2 μg/min (group Ⅱ) or atropin (0.04 mg/kg) imjection (group Ⅲ) were greater than the dose for the baseling state (group Ⅰ). In conclusion,changes in the autonomic nervous system may modulate the ATP dosage required for the termination of SVT.