体外反搏对X综合征患者血管内皮功能的保护作用

The Protective Effect of Extracorporeal Counterpulsation on the Endothelial Dysfunction in Patients with Syndrome X

目的观察体外反搏对X综合征患者血管内皮功能的保护作用。方法采用随机、对照、单盲方法将30例X综合征患者分为体外反搏组(n=15)和常规治疗组(n=15)。疗程均为3周。另外正常组(20例)不予任何治疗。疗程前后分别采用高分辨率血管超声检测肱动脉血流介导的血管舒张(FMD)功能变化,并测定血中内皮素1(ET-1)含量。结果 X综合征患者FMD功能较正常组明显减弱,差异有显著性,血中内皮素1(ET-1)水平明显高于正常组,差异有显著性(P<0.01)。体外反搏组与常规治疗组疗程前肱动脉FMD功能无明显差异,疗程后体外反搏组肱动脉FMD功能明显增强,与常规治疗组比较差异有显著性,ET-1含量亦显著减少(P<0.01)。结论体外反搏可显著改善X综合征患者的血管内皮功能异常,保护血管内皮功能可能是体外反搏抗心绞痛作用的重要机制之一。

Aim To examine the protective effect of extracorporeal counterpulsation on endothelial dysfunction in patients with syndrome X. Methods Thirty patients with syndrome X were divided into extracorporeal counterpulsation group（n = 15） and routine treatment group（n = 15） in a randomized or single blind trial. Before and after the treatment,treatment for 3 weeks,the level of plasma endothelin-1（ET-1） was assayed,the flow-mediated dilatation（FMD） function in brachial artery was measured by high-resolution ultrasound,and the normal group was without any treatment. Results In patients with syndrome X,the FMD function in artery was much reduced,the level of plasma ET-1 was greatly increased compared with healthy people. Before treatment the FMD function in extracorporeal counterpulsation group was not different from that of routine treatment group. After treatment the FMD function in extracorporeal counterpulsation group was markedly increased and plasma ET-1 was decreased compared with routine treatment group. Conclusion In patients with syndrome X there are endothelial lesion and endothelium-dependent vasodilatation dysfunction. Extracorporeal counterpulsation is very effective in the increasing of FMD function and relieving of myocardial ischemia in patients with syndrome X.