探究口服地西泮联合美托洛尔对行冠状动脉CTA患者等待时间的影响与最佳给药时间

Research on the effect of oral Diazepam combined with Metoprolol on the waiting time for patients undergoing coronary CTA and the optimal dosing time

目的探讨口服地西泮联合美托洛尔在多层螺旋CT冠状动脉成像(CCTA)中减少患者等待时间的临床应用价值及其最佳的给药时间。方法对符合入选标准的173例CCTA检查前心率≥80次/分钟的患者随机分为两组:A组(n=88)口服美托洛尔50 mg与5 mg地西泮干预,B组(n=85)单纯服用美托洛尔50 mg;记录两组患者性别、年龄、BMI及服药后30 min、45 min、60 min、75 min各时间段的心率,当心率达到≤70次/分钟时进行CCTA检查。结果A组患者心率降低至≤70次/分钟所需的时间为(47.39±11.6)min,小于B组患者(52.59±13.2)min(t=2.755,P<0.01);A组中75.00%(66/88)的患者在45 min时心率降至≤70次/分钟,而B组中仅47.05%(40/85)的患者在45 min时心率降至≤70次/分钟,两组比较差异有统计学意义(χ^2=14.225,P<0.01)。比较A组各时间段内心率受控患者的平均年龄[30 min(50.1±3.85)岁vs 45 min(53.8±7.04)岁vs 60 min(57.1±7.22)岁vs 75 min(63.2±5.56)岁;F=6.594,P<0.01]、BMI[30 min(21.0±1.60)vs 45 min(20.9±1.52)vs 60 min(21.8±1.91)vs 75 min(22.6±1.28);F=2.928,P<0.05]的差异具有统计学意义,平均年龄、BMI越大,所需等待时间越长;而性别及检查成功率差异均无统计学意义(P>0.05)。结论在进行CCTA检查前口服地西泮可明显缩短患者等待时间,且等待时间与年龄、BMI指数有关,而口服地西泮最佳时间为CCTA检查前45 min。

Objective To explore the clinical application value of oral Diazepam combined with Metoprolol in reducing patients’waiting time in multi-slicespiral CT coronary computer tomo-graphy angiography(CCTA)and observe the optimal dosing time.Methods 173 patients meeting the inclusion criteria with heart rate≥80 beats/min before CCTA examination were randomly divided into two groups:Group A(n=88)was treated with oral Metoprolol(50 mg)and Diazepam(5 mg),and group B(n=85)was given Metoprolol(50 mg)alone.The gender,age,BMI and the heart rates at 30,45,60 and 75 minutes after taking the drug in the two groups were recorded.CCTA examination was performed when the heart rate was lower than 70 beats/min.Results The time required for heart rate reduction to≤70 beats/min in group A was(47.39±11.6)minutes,less than(52.59±13.2)minutes in group B(t=2.755,P<0.01).Seventy-five percent(66/88)of patients in group A had their heart rates dropped to≤70 beats/min at 45 minutes after taking the drug.However,only 47.05%(40/85)of patients in group B had their heart rates dropped to≤70 beats/min at 45 minutes after taking the drug,so the difference between the two groups was statistically significant(χ^2=14.225,P<0.01).Comparisons of the average ages of patients with controlled heart rate at different time periods in group A[30 minutes(50.1±3.85)years old vs 45 minutes(53.8±7.04)years old vs 60 minutes(57.1±7.22)years old vs 75 minutes(63.2±5.56)years old;F=6.594,P<0.01]and comparisons of BMI[30 minutes(21.0±1.60)vs 45 minutes(20.9±1.52)vs 60 minutes(21.8±1.91)vs 75 minutes(22.6±1.28);F=2.928,P<0.05]showed statistically significant differences.The higher the average age and BMI,the longer the waiting time was required.There was no significant difference in gender and examination success rate(P>0.05).Conclusion Taking Diazepam orally before CCTA examination can significantly shorten the waiting time of patients,which is related to age and BMI.The best time for taking Diazepam orally is at 45 minutes before CCTA examination.