体外反搏在缺血性脑血管病康复中的作用与机制

尽管治疗手段在发展,缺血性脑血管疾病仍是致死和致残的主要原因。体外反搏可增加脑血流灌注,可降低缺血区域的神经细胞损害。国内体外反搏治疗缺血性脑血管疾病的临床研究结果提示该方法有效、安全及不良反应轻微,但由于大多存在研究设计的缺陷,未能提供充足的临床证据。国外有限的研究提示了体外反搏对缺血性脑血管疾病具有良好的治疗效果。体外反搏对脑血管病的治疗机制尚未完全阐明,可能与增加脑部血流灌注,增加侧支循环形成,改善血管内皮功能及促进血管新生和脑重塑有关。体外反搏可能是一种很有潜力的缺血性脑血管疾病的治疗和辅助治疗手段,但期待更多前瞻性、随机对照临床试验的证实。

Enhanced External Counterpulsation:A Novel Rehabilitation Modality of Ischemic Cerebral Vascular Disease

Ischemic cerebral vascular disease is a major cause of death and disability despite the rapid progress in management. En- hanced external counterpulsation （ EECP） has shown to increase cerebral perfusion, therefore protect neurons from damage in the ischemic re- gion. Preliminary investigations in China and other countries suggested that EECP might be an effective and safe intervention with few side- effects, but favorable clinical outcome in patients with stroke, although well-designed clinical trials are lacking. The mechanisms of action of EECP are still poorly understood and might be contributed to increasing brain perfusion, establishing collateral circulation, promoting endothe- lial function, angiogenesis and brain remodeling. Future studies are needed to delineate the therapeutic value of EECP for the treatment of is- chemic cerebral vascular disease and subsequently its possible mechanisms.