不同对比剂对双源CT冠状动脉成像中患者心率的影响

目的 探究双源CT冠状动脉成像中,静脉注射碘克沙醇320与碘普罗胺370对比剂对患者心率的影响.方法 回顾性搜集行冠状动脉CTA检查的389例患者的病例资料,根据注射对比剂不同分为2组,A组采用碘克沙醇320,B组采用碘普罗胺370,记录CT增强扫描前屏气状态下心率(基础心率)、扫描过程中注射对比剂时屏气状态下心率(注射时心率).基础心率<75次/min时,舌下含服硝酸甘油0.25 mg.比较所有患者注射对比剂前后的心率变化并对2组患者的心率变化进行比较.结果 注射对比剂后心率变化>10次/min的患者A组有8例(4.4%),B组有10例(4.8%),2组无统计学差异(P>0.05).经静脉内注射对比剂时,2种对比剂均使患者心率减低(碘克沙醇下降4.2次/min、碘普罗胺下降2.7次/min,P>0.05),服用硝酸甘油均减轻对比剂对心率的影响.结论 经静脉注射碘克沙醇320与碘普罗胺370后,均约有4%的患者心率变化>10次/min,2种对比剂对心率的影响是一致的.

Comparison of the effect of different contrast to the heart rate during coronary dual-source CT angiography

Objective To investigate the influence of iodixanol-320 and iopromide-370 on the heart rate of patients in coronary dual-source CT angiography (CTA).Methods The data of 389 patients underwent coronary CTA examinations were retrospectively collected and received contrast media (CM) with either iodixanol-320 (group A) or iopromide-370 (group B), randomly.The heart rate before CM injection (predose HR), during injection (postdose HR) were both recorded.As for the preclinical protocol, patients with heart rate less than 75 beats per minute were pretreated with nitrates (n=278),0.25 mg.Mean heart rate changes from pre to postdose HR were assessed.Results The patients whose mean heart rate changes from pre to postdose were larger than 10 beats per minute was 8(4.4%) for group A and 10(4.8%) for group B.No statistically differences were observed between them(P>0.05).With only intravenous injections of two contrast agents, the patients' heart rates decreased in both groups (4.2 vs 2.7 beats per minute,P>0.05), while the effect could be reduced by nitrates.Conclusion There is no difference in the heart rate between the 2 agents after intravenous injection of either iodixanol-320 or iopromide-370 in coronary CTA with approximately 4% patients whose mean heart rate changes from preto postdose were larger than 10 beats per minute in each group.