The Clinical Application Of Esmolol In Spiral CT Coronary Angiography

Background and ObjectiveHeart rate on image quality is directly related to the influence of diagnosis and indication selection. Due to velocity and frequency of coronary artery mainly related to heart rate, so that appropriate control patients’heart rate can help reduce or eliminate the motion artifacts of coronary artery, improve coronary CT image quality. A number of studies both at home and abroad have shown that in patients undergoing coronary CTA, control of less than60beats per minute, the acquisition of the images are more satisfied with clinical use. The current clinical use oral metoprolol control heart rate before inspection, but the drug works slowly; Drug metabolism is long; At the same time patients with a genetic polymorphism, so the response to oral metoprolol is not sensitive. The distribution of the short half-life of esmololin is only2minutes, elimination’s half-life is about9minutes. Its rapid effect and shorter half-life can obtain desired clinical effect in a few minutes. This study To discuss the clinical effect of intravenous esmolol before spiral CT coronary angiography to reveal the clinical significance of esmololin in spiral CT coronary angiography,guiding the clinical application.Methods96patients with clinically suspected coronary artery disease were scheduled for corconary CTA.The patients were randomly divided into intravenous esmolol experimental group and oral metoprolol group, then according to the heart rate were divided into>60times/minute,>65times/minute,>70times/minute,>80times/minute4groups in check. Record drugs work time and heart rate before the inspectionduring the process of inspection,and ten minutes after the inspection record. Using SPSS17.0statistical software for statistical, measurement data using t test and single factor variance analysis, counting data using x2test,theoretical frequency t<1or n<40, the Fisher’s exact probability calculation method, P<0.05as was statistically significant, P <0.01for significant statistical significance.Results1. There is no statistical difference of the drug effect time of each group in90minutes (P>0.05), the drug effect time comparison between the two groups h ave statistically significant difference (P<0.01). Comparison of drug effect time between groups Al, B1, between groups A2, B2, between groups A3, B3, betwe en groups A4, B4have statistically significant difference (P<0.01).2. comparison of Heart rate fluctuation range:There is no statistical difference of heart rate fluctuation range of esmolol group and metoprolol group (P>0.05), heart rate fluctuation comparison between the two groups have statistically si gnificant difference (P<0.05). Comparison of heart rate fluctuation between grou ps A1, B1, between groups A2, B2, between groups A3, B3, between groups A4, B4have statistically significant difference (P<0.05).ConclusionEsmolol group and metoprolol group all have certain effect to control the heart rate of patients in spiral CT coronary angiography, but the effect of controlling the heart rate during the process and the onset time of esmolol are obviously superior to the metoprolol group.