盐酸艾司洛尔在低剂量冠状动脉CT大螺距前瞻性双次扫描中的应用价值

Application of intravenous esmolol in low dose, high-pitch dual-source CT coronary angiography

目的评价静脉注射艾司洛尔在低剂量冠脉CT大螺距前瞻性双次扫描(Double Flash)中的应用价值。方法选取于2013年3-10月在解放军总医院心内科采用Double Flash模式行CT冠脉成像(CT coronary angiography,CTCA),并且扫描前心率低于65/min的319例患者。根据是否静脉应用艾司洛尔控制心率,将入选患者分为A组(注射艾司洛尔)157例和B组(未注射艾司洛尔)162例,比较两组患者心率变化、图像质量和接受辐射剂量。结果扫描指令下达时心率A组[(56.17±4.94)/min]低于B组[(61.22±3.79)/min](P<0.05);图像质量Likert评分A组(3.29±0.36)高于B组(3.12±0.37)(P<0.05);两组辐射剂量分别为A组(1.75±0.58)m Sv,B组(1.86±0.69)m Sv(P>0.05)。结论对于行Double Flash患者,扫描前静脉应用艾司洛尔控制心率,可有效提高重建图像质量,具有较高的临床应用价值。

Objective To evaluate the application of intravenous esmolol in low dose, high-pitch dual-source CT coronary angiography （Double Flash）.Methods Three hundred and nineteen patients who received Double Flash with heart rates under 65 beats/min before scanning from March to October in 2013 in Chinese PLA GeneralHospital were enrolled in this study and divided into two groups. Group A received intravenous esmolol （n=157）, while group B （n=162） did not receive it. Clinical characteristics, changes in heart rates, image quality and the mean effective radiation dose between two groups were compared in order to evaluate the application of intravenous esmolol in Double Flash.Results Heart rates at the beginning of scanning order in group A were significantly lower than group B （56.17±4.94vs 61.22±3.79,P〈0.05）. The score of Likert in image quality of group A were significantly higher than group B （3.29±0.36vs 3.12±0.37,P〈0.05）, while no significant difference was found in mean effective radiation dose between two groups （1.75±0.58vs 1.86±0.69,P〉0.05）.Conclusion For patients who receive Double Flash, the application of intravenous esmolol can effectively control their heart rates during the scanning and improve the image quality, which shows high value in clinical application.