64层螺旋CT冠状动脉血管成像交替口服倍他乐克和阿替洛尔的临床观察

Clinical observation on preparation of coronary CTA with oral betaloc and atenolol

目的探讨冠状动脉64层螺旋CT血管成像(CTA)检查前交替口服倍他乐克和阿替洛尔的临床疗效和有效服药剂量。方法临床疑诊为冠心病预接受冠状动脉CTA检查,心率>70次/分的患者48例,先口服1片(25mg/片)倍他乐克,服药后每隔30分钟测量一次心率及血压。若60min后还未达目标心率(≤70次/分),再含服阿替洛尔1片(25mg/片),并按同样方法进行测量。若仍未达要求,则再追加1片阿替洛尔及进行测量,直至达到目标心率。重复服用倍他乐克和阿替洛尔最大剂量不超过4片(100mg)。按不同基础心率,把患者分为两组,A组为低心率组:>70次/分、≤80次/分;B组为高心率组:基础心率≥80次/分。结果48例患者口服倍他乐克和阿替洛尔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46.3min和84.7min。A、B组中,服2片以上药物的病例比率分别为9.5%和55.6%。结论基础心率越高,服药后达目标心率的时间越长,服药剂量也越大。口服适当剂量的他乐克和阿替洛尔可安全、快捷、有效地减慢心率,有助于冠脉CTA高质量图像的获得。

Objetive To Evaluate the clinical onset time and effective dosage of Betaloc and Atenololo on preparation of coronary computed tomography （CTA）. Methods Fourty-eight patients with clinically suspected coronary artery disease and heart rate 〉 70/min were scheduled for corconary CTA.Blood pressure （BP） and heart rate （HR） were monitored at an interval of 30min after a pill of Betaloc（25mg/min ）was buceally taken. A pill ofAtenololo （25mg/min）should be medicated if the HR didn＇t reach the target （〈=70/min）60 rain later.but Betaloc and Atenololo pills counldn＇t more than 100 mg. BP and HR were tracked the same as before. Fourty-eight patients were divided into group A （basic HR range from 70 to 80/min） and group B （〉80/min）. Results The HP of 48 patients were successfully decreased time was 46.3 and 84.7 min in groups Aand B respectively.The rate of patients taking 2 or more than 2 pills of Betaloc and Atenololo in groups Aang B was 9.5% and 55.6% respectively. Conclusion The rapider the basic HR were,the longer the effective time and the larger the dosage.Sufficient quantum of sublingual Betaloc and Atenololo is effective,rapid and safe in decreasing HR,which is benefit for patients scheduled for corconary CTA.