体外反搏作用的新机制及其装置的新发展

New Mechanism of EECP Therapy and Exploration of Modern EECP Device

体外反搏已被实践证明是一项安全、有效和经济的心、脑血管疾病治疗方法,并于2002年正式纳入美国心脏协会/美国冠心病学会(AHA/ACC)的冠心病心绞痛临床治疗指南。作者近10年来研究证实:体外反搏能提高血流切应力、改善血管内皮细胞功能、防止动脉粥样硬化性损伤;在动脉粥样硬化实验猪模型上,也证实了体外反搏不仅可以改善血流灌注,还可以通过提高血流切应力,调节一系列血管内皮活性物质,达到保护血管内皮,抑制动脉硬化的目的。上述新作用机制的发现,促进了新型体外反搏装置的深入研制,推进体外反搏的临床应用,在冠心病、动脉粥样硬化性疾病的一级和二级预防领域中发挥着重要的作用。

Enhanced external counterpulsation （EECP） has bee proved to be an effective, safe, and economical therapy for the management of ischemic cardiovascular and cerebrovascular diseases, which was introduced in the AHA/ACC Guideline of Coronary Artery Disease in 2002. Recent decade, EECP has been proved to be able to augment shear stress of blood flow and thus improve the function of vascular endothelial cells （VEC）, which in turn inhibits the progress of atherosclerosis. Based on our background of EECP study, we had recently documented on porcine models of atherosclerosis that the therapeutic effects of EECP on cardiovascular diseases lie not only in increasing coronary blood flow and promoting coronary collaterals, but in increasing shear stress of blood flow, regulating a series of reaction of shear-stress-responsive elements, inducing VEC repair mechanisms, improving VEC functioning, all of which contributes to the inhibition of the development of atherosclerosis. Those findings result in the development of a new model of EECP equipment serving not only in secondary, but primary prevention of atherosclerotic disease. The breakthrough we made by utilizing EECP therapy may bring a promising future of EECP in China for its technological development as well as its clinical promotion.