Takada Yukimasa, Kawagishi Toshiya, Kii Natsumi, Higuchi Misako, Yamauchi Masanori, Yamakage Michiaki
Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo 060-8543.
Masui. 2013 Apr;62(4):402-5.
We report three cases (73-year-old, 69-year-old and 76-year-old men) of bronchospasm induced by adenosine triphosphate (ATP) during thoracic endovascular aortic repair (TEVAR). Severe broncospasm occurred soon after administration of ATP to obtain transient asystole during TEVAR. All three cases were complicated with asthma or chronic obstructive pulmonary disease (COPD) before TEVAR, and airway hyper-reactivity was suspected. One case (73-year-old) required postoperative intensive care to treat bronchospasm, and the other two cases recovered during the operation. The possible mechanism of adenosine-induced bronchoconstriction is selective interaction with active mast cells with subsequent release of preformed and newly formed mediators. Careful attention should be paid when ATP is injected during TEVAR in patients with asthma or COPD.
我们报告了3例（分别为73岁、69岁和76岁男性）在胸主动脉腔内修复术（TEVAR）期间由三磷酸腺苷（ATP）诱发支气管痉挛的病例。在TEVAR期间给予ATP以获得短暂心脏停搏后不久即发生了严重支气管痉挛。所有3例患者在TEVAR术前均合并哮喘或慢性阻塞性肺疾病（COPD），怀疑存在气道高反应性。1例（73岁）患者术后需要重症监护来治疗支气管痉挛，另外2例在手术过程中恢复。腺苷诱发支气管收缩的可能机制是与活性肥大细胞选择性相互作用，随后释放预先形成的和新形成的介质。对于哮喘或COPD患者，在TEVAR期间注射ATP时应予以密切关注。
