摘要
评价终止阵发性室上性心动过速 (PSVT)所需的中心静脉和外周静脉最低有效腺苷剂量及其安全性和有效性。 31例入选患者均无器质性心脏病 ,高血压病 2例 ,男 17例、女 14例 ,年龄 41.3± 18.0 (15～ 6 7)岁。房室结折返性心动过速 (AVNRT) 13例、房室折返性心运过速 (AVRT) 18例。当PSVT持续 1min后 ,经中心和外周静脉以初始剂量 3mg快速注射腺苷 ,如无效以 3mg递增直至最大剂量达 18mg。比较两种静脉途径的反应情况。结果 :中心静脉给药时 ,最低有效剂量为 3mg者 2 4例 (77.4% )、6mg者 9例 (2 9.0 % )。外周静脉最低有效剂量为 6mg者 12例(38.7% )、9mg者 14例 (4 5 .2 % )、12mg者 4例 (12 .9% )、1例需 15mg。中心静脉最低有效剂量为 3.7± 1.3mg ,明显低于外周静脉 (8.4± 2 .4mg) ,P <0 .0 1;复律时间短于外周静脉 (13.5± 4.3vs2 2 .0± 7.8s) ,P <0 .0 0 1。两种途径的副作用发生率、终止后心律失常、复律后最长RR间隙无显著差异。腺苷终止PSVT后 ,动脉收缩压升高 18.1±9.1mmHg ,10s后恢复至给药前的窦性心律水平 ,对舒张压无显著影响。静脉快速注射腺苷能安全有效地终止PSVT ,对动脉血压无不良影响 ,初始中心静脉剂量应为 3mg。
This study was done to evaluated the minimal effective doses and the safety and efficacy of central and peripheral adenosine administration for treatment of paroxysmal superventricular tachycarida(PSVT).Thirty one patients with PSVT underwent invasive electrophysiologic study and were treated with peripheral and central intravenous administration of adenosine .The study population consisted of 17 males and 14 females,ages 15 to 67 (41.3± 18.0) years and includes 18 patients with AVRT,13 with AVNRT.No patient had evidence of organic heart disease except two patients with hypertention.During episodes of PSVT lasting more than 1 minute,rapid intravenous injection of adenosine were given centrally and peripherally.The initial dose was 3 mg,if no effect was observed,the dose for subsequent injection was increased in 3 mg increment until the tachycardia was terminated.Peripheral responses were compared with those obtained centrally.The tachycardia was terminated in 24 patients (77.4%) with 3 mg,and in 9 (29.0%) with 6 mg after central administration.In contrast,after peripheral administration,tachycardias was terminated in 12 patients (38.7%) with 6 mg,in 14 (45.2% ) with 9 mg,in 4 (12.9% ) with 12 mg and 1 patient with 15 mg.The mean minimal effective central dose (3.7±1.3 mg) was significantly lower than the peripheral dose(8.4±2.4 mg)( P <0.001).The time from adenosine injection to termination of tachycardia was shorter after central administration than after peripheral (13.5±4.3 and 22.0±7.8 s,respectively, P <0.001).There was no difference between the two routes of drug administration in the incidence of side effects or transient arrhythmias and the longest RR interval at the time of tachycardia termination.At the point when PSVT was interrupted with adenosine the systolic blood pressure increased 18.1±9.1 mmHg over that observed during the tachycardia and 10 s later changed to that during normal sinus rhythm,where as there was no significant change in diastolic blood pressure.Adenosine can be safely given intravenously for termination of PSVT without adverse effect on blood pressure.Initial dose for central route should be 3 mg.
出处
《中国心脏起搏与心电生理杂志》
2001年第6期399-401,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
室上性心动过速
阵发性
腺苷
心脏复律
Supraventricular tachycardia,paroxysmal Adenosine Cardioversion
