增强型体外反搏对稳定型心绞痛患者血管内皮功能的影响
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摘要
目的探究增强型体外反搏(EECP)对稳定型心绞痛患者血管内皮功能的影响。方法采用前瞻性研究方法,分析2014年4月至2016年3月成都新华医院心内科收治的156例慢性稳定型心绞痛患者的临床资料,按照随机平行分组法随机分为观察组和对照组,每组各78例。对照组患者采用常规综合治疗,观察组患者在此基础上加以EECP装置治疗。两组患者治疗6周后,对比两组患者治疗前后血管内皮功能各指标变化及临床疗效。结果两组患者治疗前后非内皮依赖性血管舒张功能(NMD)无明显变化(P> 0. 05);两组患者治疗后的内皮依赖性血管舒张功能(FMD)、峰值流速变化率及一氧化氮(NO)水平均高于治疗前(P <0. 05),其中以观察组治疗后各指标增高更为显著,组间比较差异具有统计学意义(P <0. 05)。观察组患者治疗后的平均每周心绞痛发病频率、平均每周心绞痛持续时间及心肌缺血总负荷均低于对照组,组间比较差异具有统计学意义(P <0. 05)。结论 EECP可改善稳定型心绞痛患者血管内皮功能,对改善心绞痛病情及心肌缺血状况有积极作用,可作为稳定型心绞痛患者重要的辅助治疗方式。
Objective To explorte the effect of enhanced external counterpulsation( EECP) on vascular endothelial function in patients with stable angina pectoris. Methods A prospective study was conducted to analyze the clinical data of 156 patients with chronic stable angina pectoris during April 2014 to March 2016 in the Department of Cardiology of Jianyang People's Hospital. Patients in control group were treated with conventional comprehensive treatment,and patients in observation group were treated with EECP device on this basis. After 6 weeks of treatment,the indexes of vascular endothelial function and clinical efficacy of these two groups were compared before and after treatment. Results There was no significant change in NMD before and after treatment in both groups( P > 0. 05); FMD,peak velocity change rate and NO level in both groups were higher than those before treatment( P < 0. 05),and the indexes in observation group were the most obvious after treatment,and the difference was statistically significant( P < 0. 05). The average frequency of angina pectoris per week,duration of angina pectoris per week and total myocardial ischemia load in observation group were lower than those of control group after treatment,and the difference was statistically significant( P < 0. 05). Conclusion EECP can improve vascular endothelial function in patients with stable angina pectoris,improve the condition of angina and myocardial ischemia has positive effect,hence it can be used as an important auxiliary treatment for patients with stable angina pectoris.
Objective To explorte the effect of enhanced external counterpulsation( EECP) on vascular endothelial function in patients with stable angina pectoris. Methods A prospective study was conducted to analyze the clinical data of 156 patients with chronic stable angina pectoris during April 2014 to March 2016 in the Department of Cardiology of Jianyang People's Hospital. Patients in control group were treated with conventional comprehensive treatment,and patients in observation group were treated with EECP device on this basis. After 6 weeks of treatment,the indexes of vascular endothelial function and clinical efficacy of these two groups were compared before and after treatment. Results There was no significant change in NMD before and after treatment in both groups( P > 0. 05); FMD,peak velocity change rate and NO level in both groups were higher than those before treatment( P < 0. 05),and the indexes in observation group were the most obvious after treatment,and the difference was statistically significant( P < 0. 05). The average frequency of angina pectoris per week,duration of angina pectoris per week and total myocardial ischemia load in observation group were lower than those of control group after treatment,and the difference was statistically significant( P < 0. 05). Conclusion EECP can improve vascular endothelial function in patients with stable angina pectoris,improve the condition of angina and myocardial ischemia has positive effect,hence it can be used as an important auxiliary treatment for patients with stable angina pectoris.
引文
[1]李吉刚.增强型体外反搏联合药物治疗冠心病不稳定型心绞痛[J].实用医药杂志,2012,29(11):977-978.
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[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
[4]张剑,刘东梅,韩建伦,等.增强型体外反搏术治疗不稳定型心绞痛临床荟萃分析[J].中西医结合心脑血管病杂志,2016,14(7):799-800.
[5]周涛,范忠才.血管内皮细胞与动脉粥样硬化的关系[J].现代医药卫生,2016,32(5):708-710.
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[7]陈小卫,黄志文,田丽红.增强型体外反搏治疗冠心病不稳定型心绞痛疗效观察[J].中国实用医药,2011,6(5):17-18.
[8]张树锋,陈英,关浩增,等.增强型体外反搏对不稳定型心绞痛患者心率变异性的影响[J].微创医学,2015,10(3):281-283.
[9]熊晨晖,李振华,陈如,等.增强型体外反搏治疗不稳定性心绞痛的效果分析[J].河南医学研究,2017,26(21):3978-3979.
[10]王晖,周艳玲,刘兴姣,等.二维斑点追踪成像技术评价体外反搏后左室整体收缩功能的早期变化[J].临床超声医学杂志,2016,18(5):312-315.
[11]杨粟毅,刘建修,朱晓东.增强型体外反搏联合药物治疗对不稳定型心绞痛患者炎症因子、hs-CRP的影响[J].深圳中西医结合杂志,2016,26(23):12-14.
[12]贾文剑,孙红霞,呼敏风.老年原发性高血压患者肱动脉血流介导的内皮依赖性舒张功能变化[J].中国老年学杂志,2012,32(7):1349-1350.
[13]陈功泉.中老年心血管病高危人群颈总动脉弹性与肱动脉非内皮依赖性血管舒张功能的相关性[J].中国老年学杂志,2014,34(11):2959-2960.
[14]刘爱国,付喜文,宋玮,等.冠心病病人冠状动脉狭窄程度与心肌缺血总负荷的相关性研究[J].中西医结合心脑血管病杂志,2015,13(18):2088-2089.
[2]段瑶,吴永全,梁金锐.不稳定型心绞痛患者血管内皮功能与微量白蛋白尿的研究进展[J].中国循证心血管医学杂志,2015,7(3):418-420.
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
[4]张剑,刘东梅,韩建伦,等.增强型体外反搏术治疗不稳定型心绞痛临床荟萃分析[J].中西医结合心脑血管病杂志,2016,14(7):799-800.
[5]周涛,范忠才.血管内皮细胞与动脉粥样硬化的关系[J].现代医药卫生,2016,32(5):708-710.
[6]刘洋.增强型体外反搏治疗冠心病的新机制[J].心血管病学进展,2016,37(2):185-188.
[7]陈小卫,黄志文,田丽红.增强型体外反搏治疗冠心病不稳定型心绞痛疗效观察[J].中国实用医药,2011,6(5):17-18.
[8]张树锋,陈英,关浩增,等.增强型体外反搏对不稳定型心绞痛患者心率变异性的影响[J].微创医学,2015,10(3):281-283.
[9]熊晨晖,李振华,陈如,等.增强型体外反搏治疗不稳定性心绞痛的效果分析[J].河南医学研究,2017,26(21):3978-3979.
[10]王晖,周艳玲,刘兴姣,等.二维斑点追踪成像技术评价体外反搏后左室整体收缩功能的早期变化[J].临床超声医学杂志,2016,18(5):312-315.
[11]杨粟毅,刘建修,朱晓东.增强型体外反搏联合药物治疗对不稳定型心绞痛患者炎症因子、hs-CRP的影响[J].深圳中西医结合杂志,2016,26(23):12-14.
[12]贾文剑,孙红霞,呼敏风.老年原发性高血压患者肱动脉血流介导的内皮依赖性舒张功能变化[J].中国老年学杂志,2012,32(7):1349-1350.
[13]陈功泉.中老年心血管病高危人群颈总动脉弹性与肱动脉非内皮依赖性血管舒张功能的相关性[J].中国老年学杂志,2014,34(11):2959-2960.
[14]刘爱国,付喜文,宋玮,等.冠心病病人冠状动脉狭窄程度与心肌缺血总负荷的相关性研究[J].中西医结合心脑血管病杂志,2015,13(18):2088-2089.