含服倍他乐克在冠状动脉CTA检查的临床观察

Clinical Observation on Preparation of Coronary CTA with Sublingual Betaloc

目的:探讨冠状动脉CT血管成像(CTA)检查前含服倍他乐克的临床起效时间及有效服药剂量。方法:临床疑诊冠心病预接受冠状动脉CTA检查,心率>65次/分的患者共96例,先舌下含服1片(25mg/片)倍他乐克,服药后每隔15min测量一次心率及血压。若60min后还未达目标心率(≤65次/分),再含服倍他乐克1片,并按同样方法进行测量。若仍未达要求,则再追加1片及进行测量,直至达到目标心率。重复服用倍他乐克最大剂量不超过4片(100mg)。按不同基础心率,把患者分为两组,A组为低心率组:基础心率>65次/分、≤75次/分;B组为高心率组:基础心率≥76次/分。结果:96例患者经舌下含服倍他乐克后心率均成功达到目标心率。所有患者均未出现明显不良反应。A、B组平均起效时间分别为44.9min和76.6min。A、B组中,服2片及以上片数药的病例比率分别为14.0%和52.8%。结论:基础心率越高,服药后到达目标心率的时间越长,服药剂量也越大。舌下含服适当剂量的倍他乐克可快速、有效、安全地减慢心率,有利于患者完成冠状动脉CTA检查。

Objective： To evaluate the clinical onset time and effective dosage of Betaloc on preparation of coronary computed tomographie angiography （CTA）. Methods： Ninety-six patients with clinically suspected coronary artery disease and heart rate ≥65/min were scheduled for coronary CTA. Blood pressure （Bp） and heart rate （HR） were monitored at an interval of 15min after a pill of Betaloc （25mg/pill） was buccally taken. Betaloe pills not more than 100mg should be medicated if the HR didn＇t reach the target HR （≤65/min） 60min later. Bp and HR were tracked the same as before. Ninety-six patients were divided into group A （basic HR range from 66 to 75/min） and group B （basic HR〉75/min）. Results： The HR of 96 patients were successfully decreased to the target HR after administration of sublingual Betaloc. There were no severe adverse drug reactions. The mean response time was 44.9 and 76.6min in groups A and B respectively. The rate of patients taking 2 or more than 2 pills of Betaloc in groups A and B was 14.0% and 52.8% respectively. Conclusion：The rapider the basic HR were,the longer the effective time and the larger the dosage. Sufficient quantum of sublingual Betaloc is effective,rapid and safe in decreasing HR,which is benefit for patients scheduled for coronary CTA.