Riccardi Alessandro, Arboscello Eleonora, Ghinatti Maria, Minuto Pierangela, Lerza Roberto
Dipartimento di Emergenza, Pronto Soccorso, Ospedale San Paolo, 17100 Savona, Italy.
Am J Emerg Med. 2008 Oct;26(8):879-82. doi: 10.1016/j.ajem.2007.11.029.
We report a retrospective analysis of 5 years of adenosine use in our emergency department (2002-2006). We treated 454 patients with an intravenous bolus of adenosine. The cohort was made up of 40.7% men and 59.3% women, with mean age of 47.32 years, mean heart rate of 162.48 beats per minute. Among them, 73% responded immediately to the 6-mg dose, 15% responded after the second 12-mg dose, and 11% responded to a further 12-mg dose, whereas 11% were unresponsive. We observed minor side effects in a high percentage of patients (ie, chest tightness 83%, flushing 39.4%, sense of impending death 7%). Only 1 major adverse effect was recorded, that is, administering 12 mg of adenosine induced a marked acceleration in the ventricular rate of a patient with an undiagnosed atrial flutter, caused by induction of atrioventricular conduction (1:1). Our results confirm that when patients are appropriately selected, adenosine is probably the best available drug to treat paroxysmal supraventricular tachycardias, especially in emergency situations.
我们报告了对我院急诊科5年（2002 - 2006年）使用腺苷情况的回顾性分析。我们对454例患者静脉推注了腺苷。该队列中男性占40.7%，女性占59.3%，平均年龄为47.32岁，平均心率为每分钟162.48次。其中，73%的患者对6毫克剂量立即有反应，15%的患者在第二次给予12毫克剂量后有反应，11%的患者对再一次给予的12毫克剂量有反应，而11%的患者无反应。我们观察到高比例患者出现轻微副作用（即胸闷83%、面部潮红39.4%、濒死感7%）。仅记录到1例严重不良反应，即给予12毫克腺苷导致1例未确诊的心房扑动患者心室率显著加快，这是由房室传导（1:1）诱发的。我们的结果证实，当患者选择适当时，腺苷可能是治疗阵发性室上性心动过速的最佳可用药物，尤其是在紧急情况下。
