体外反搏改善冠心病血管内皮依赖性舒张功能的效果与评价

目的评价体外反搏改善冠心病病人血管内皮依赖性舒张功能的效果。方法随机将70例冠心病心肌缺血病人分为两组,其中35例在常规药物基础上加用体外反搏治疗为体外反搏组,其他35例应用常规药物治疗为常规治疗组。治疗前后进行动态心电图及彩色多普勒超声检测,对缺血及血管内皮依赖性舒张功能的相关指标作对比观察。结果治疗12周后,症状性与无症状性心肌缺血的次数及其持续时间,两组均有明显减少及缩短,与治疗前比较,有显著性差异(P<0.01),两组疗效比较体外反搏组明显优于常规治疗组(P<0.05)。体外反搏组血管内皮依赖性舒张功能指标(FMD)与反搏前比较明显改善(P<0.01),与常规治疗组比较差异亦非常显著(P<0.01)。两组的非依赖性血管内皮舒张功能(NID)治疗前后均无显著变化(P均>0.05)。反搏期间病人无不良反应。结论体外反搏对冠心病病人不仅能减少心肌缺血的发作,而且有改善血管内皮依赖性舒张功能的作用。

Estimating the effect of external counterpulsation therapy improves Endothteliam-Dependent Dilation function in patients with coronary heart disease

Objective To estimate the effect of enhanced external counterpulsation(EECP) on endotheliam dependent dilation function(EDDF) with coronary heart disease(CHD).Methods Seventy CHD patients with myocardial ischemic were randomly into EECP group(n=35)and routine group(35).The routine group was treated with normal treatment aspirin,metoprolol,sorbitrate and pravastatin,the EECP group was treated with EECP based on the normal treatment.The changes of myocardial ischemic and EDDF were observed by Dynamicelectrocardiogram and Dopple ultrasound before and after treatment.Results Frequency and sustained time of symptomatic and asymtomatic myocardial ischemia were decreased significantly in two groups(P<0.01 respectively) after therapy of 12 weeks,but it decreased more significantly(P<0.05) in EECP group than in routine group.EDDF parameter(FMD) was improved(P<0.01) in the EECP group after treatment,it was better(P<0.01) than that in routine group.However,there were no significantly change of vasodilation in both groups(P>0.05 all) after treatment.No side effects found in treating with EECP.Conclusion EECP therapy not only decreases frequency and sustained time of myocardial ischemic but also improves EDDF in CHD patients.