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目的对比口服和舌下含服酒石酸美托洛尔两种给药途径对冠状动脉CT血管成像(冠脉CTA)图像质量和检查耗时的影响。方法选取2015年2~11月在重庆市第五人民医院接受冠脉CTA检查的80例患者随机分为口服组和舌下含服组,每组各40例。口服组给予酒石酸美托洛尔25 mg,温开水吞服;舌下含服组给予酒石酸美托洛尔片25 mg,舌下含服。服药后每隔15 min测量心率和血压,若心率降至65次/min及以下,立即行冠脉CTA。若60 min后还未达目标心率(≤65次/min),则同样方法重复给药,直至达到目标心率。重复给药最大剂量不超过100 mg。比较两组冠脉CTA图像质量和检查耗时。结果两组患者的一般情况比较,差异无统计学意义(P>0.05),所有患者服用酒石酸美托洛尔后均成功达到目标心率。舌下含服组图像质量Ⅰ级率明显高于口服组(P<0.05),检查时间明显短于口服组(P<0.05),酒石酸美托洛尔用量也明显少于口服组(P<0.05)。结论在冠脉CTA检查前舌下含服酒石酸美托洛尔较口服方式更能提高冠脉CTA的图像质量,缩短检查时间。
OBJECTIVE: To compare the effects of oral and sublingual metoprolol administration on coronary angiography (CTA) image quality and time spent on examination. Methods Eighty patients randomly assigned to coronary CTA at the Fifth People’s Hospital of Chongqing from February to November 2015 were randomly divided into oral group and sublingual group, 40 in each group. The oral group was given metoprolol tartrate 25 mg, swallowed in warm water; sublingual group was given metoprolol tartrate tablets 25 mg, sublingual. Heart rate and blood pressure were measured every 15 minutes after taking the medicine. If the heart rate dropped to 65 beats / min and below, coronary CTA was performed immediately. If the target heart rate (≤65 beats / min) is not reached after 60 min, the same method is repeated until the target heart rate is reached. The maximum dose of repeated administration does not exceed 100 mg. Comparison of coronary CTA image quality and time-consuming in both groups. Results There was no significant difference between the two groups in general condition (P> 0.05). All patients successfully achieved target heart rate after taking metoprolol tartrate. The grade Ⅰ of the sublingual group was significantly higher than that of the oral group (P <0.05), the test time was significantly shorter than that of the oral group (P <0.05), and the dosage of metoprolol tartrate was significantly lower than that of the oral group (P < 0.05). Conclusions Metoprolol sublingual can significantly improve the quality of coronary CTA and shorten the examination time compared with oral administration before sublingual CTA.