摘要
目的探讨冠脉CTA检查前口服伊伐布雷定的安全性与有效性。方法选择2020年4月~2021年3月在江门市新会区人民医院行冠脉CTA检查的患者共210例,随机分为三组:A组和B组患者分别在检查前1 h口服伊伐布雷定5 mg(A组,n=70)或7.5 mg(B组,n=70),C组患者在检查前1 h口服美托洛尔50 mg(n=70)。观察各组患者入院(门诊)就诊时(T0)、入室扫描前(T1)、扫描期间(T2)的心率、血压与心率达标率(T2<70次/分),单次检查成功率、不良反应(如心功能不全及严重心律失常)等,并评估分节段冠脉图像质量。结果三组患者研究基线齐同可比,T0时心率分别为(77.5±14.6)、(75.4±17.9)、(76.2±20.3)次/分,T1时B组患者心率较T0下降(14.6±4.1)次/分,较A组(12.2±4.7)次/分及C组(10.1±5.6)次/分明显降低,差异均具有统计学意义(P<0.001);三组患者T2时心率达标率分别为78.6%、91.4%、82.9%,一次检查成功率分别91.4%、95.7%、88.6%,B组均优于A、C两组,但组间差异无统计学意义(P=0.1038、P=0.2964);分析冠脉节段图像质量,三组0级图像分别有8、4、18个节段,B组图像分级较高、质量较好,组间差异具有统计学意义(P=0.015);T1收缩压下降(5.3±3.6)、(6.5±3.9)、(13.8±7.7)mmHg,舒张压下降(4.5±2.1)、(4.9±3.7)、(7.8±5.6)mmHg,C组血压差较大,差异均具有统计学意义(P<0.001)。三组患者均无报告或记录不良反应。结论行冠脉CTA检查前使用伊伐布雷定可以提高检查成功率,适宜在临床上尤其是没配备科学研究型CT设备的基层医院推广应用。
Objective To investigate the safety and efficacy of oral ivabradine tablets before coronary CTA(computed tomography angiography)examination.Methods A total of 210 patients who underwent coronary CTA in Jiangmen Xinhui District People's Hospital from January to December 2020 were randomly divided into three groups:group A and group B were given oral ivabradine 5 mg(group A,n=70)or 7.5 mg(group B,n=70)1 hour before the examination,and group C was given oral metoprolol 50 mg(n=70)1 hour before the examination.The heart rate,blood pressure and heart rate compliance rate(T_(2)<70 beats/min),success rate of single examination,adverse reactions(such as cardiac insufficiency and severe arrhythmia)of patients in each group were observed at admission(outpatient)visit(T_(0)),before in room scanning(T_(1))and during scanning(T_(2)),and the image quality of segmental coronary artery was evaluated.Results The baseline of the three groups was comparable.The heart rate at T_(0) was(77.5±14.6)、(75.4±17.9)、(76.2±20.3)beats/min respectively.Comparison of heart rate at T_(0),the decrease in heart rate of group B was(14.6±4.1)beats/min at T_(1),lower than(12.2±4.7)beats/min in group A and(10.1±5.6)beats/min in group C,and the differences were statistically significant(P<0.001).The rate of Heart rate up to test standard at T_(2) of the three groups was 78.6%,91.4%,82.9%,and the success rate of one-time examination was 91.4%,95.7%,88.6%,which was significantly higher than that in group B(P<0.001).Compared with group A and C,there was no significant difference in three groups(P=0.103,8,P=0.296,4).Analysis of the image quality of coronary segments showed that there were 8,4 and 18 segments in grade 0 images of the three groups,and there was significant difference in three groups(P=0.015);Systolic blood pressure at T_(1) decreased by(5.3±3.6),(6.5±3.9)and(13.8±7.7)mmHg,diastolic blood pressure decreased by(4.5±2.1),(4.9±3.7)and(7.8±5.6)mmHg.the difference of blood pressure in group C was significant(P<0.001).No adverse rea
作者
谭晓晖
林嘉诚
谭仲伦
朱可云
TAN Xiao-hui;LIN Jia-cheng;TAN Zhong-lun(Department of Cardiovasology,Xinhui People’s Hospital of Jiangmen City,Xinhui Hospital Affiliated to Southern Medical University,Jiangmen 529100,China)
出处
《中国处方药》
2021年第11期14-17,共4页
Journal of China Prescription Drug
基金
广东省医学科学技术研究基金项目(B2015145)
广东省医学科研基金指令性课题(C2020105)
