Giagounidis A A, Schäfer S, Klein R M, Aul C, Strauer B E
Universität Düsseldorf, Abteilung für Hämatologie, Onkologie und klinische Immunologie, MNR- Klinik, Moorenstr. 5, D-40225 Düsseldorf, Germany.
Eur J Med Res. 1998 Aug 18;3(8):380-2.
Adenosine is widely used to terminate paroxysmal supraventricular tachycardia. However, it is usually considered of no value in patients on theophylline, for methylxanthines completely antagonize the A(1) -receptor mediated negative dromotropic adenosine effect. We report a case of a 69 year old man who had chronic obstructive lung disease and spontaneous pneumothorax. Supraventricular tachycardia with a heart rate of 200 bpm persisted even after a pleural drain was inserted and the lung became fully inflated. Although the patient was on theophylline medication with effective serum plasma levels, adenosine terminated the supraventricular tachycardia after three repeated doses of 3, 6 and 9 mg, respectively. This observation further nourishes previous hypotheses that chronic administration of an A1-receptor antagonist leads to up-regulation of the adenosine receptor number.
腺苷被广泛用于终止阵发性室上性心动过速。然而，对于使用茶碱的患者，通常认为腺苷没有作用，因为甲基黄嘌呤完全拮抗A(1)受体介导的负性变传导性腺苷效应。我们报告一例69岁男性患者，患有慢性阻塞性肺疾病和自发性气胸。即使插入胸腔引流管且肺完全复张后，心率为200次/分钟的室上性心动过速仍持续存在。尽管该患者正在使用茶碱药物且血清血浆水平有效，但分别给予3 mg、6 mg和9 mg的腺苷重复三次给药后，终止了室上性心动过速。这一观察结果进一步支持了先前的假说，即长期给予A1受体拮抗剂会导致腺苷受体数量上调。
