增强型体外反搏治疗进展性卒中对早期动脉粥样硬化斑块的影响

Effects of enhanced external counterpulsation therapy on progressing stroke to the early atherosclerotic plaque

目的:探讨增强型体外反搏治疗进展性卒中对早期动脉粥样硬化斑块的影响。方法:根据随机数字表法将130例进展性卒中患者分为治疗组与对照组,每组各65例,2组均给予常规药物治疗,在此基础上治疗组加用增强型体外反搏治疗。结果:治疗组与对照组治疗前的颈动脉内中膜厚度(IMT)分别为(1.89±0.31)mm和(1.88±0.42)mm,治疗后分别为(1.18±0.56)mm和(1.45±0.34)mm,治疗后治疗组的颈动脉IMT低于对照组(P<0.05)。2组患者治疗后的斑块负荷和斑块面积较治疗前均有减少(P<0.05),且治疗后治疗组的斑块负荷、斑块面积均低于对照组(P<0.05)。2组治疗后的血清P-选择素和纤维蛋白原含量较治疗前均有下降(P<0.05),且治疗后治疗组的血清P-选择素和纤维蛋白原含量均明显低于对照组(P<0.05)。2组治疗后斑块性质均呈现硬化趋势,与治疗前比较差异有统计学意义(P<0.05),且治疗后治疗组的斑块性质好于对照组(P<0.05)。结论:增强型体外反搏治疗进展性卒中能有效发挥改善凝血与纤溶功能的作用,防止易损斑块的形成,降低斑块负荷、斑块面积和颈动脉IMT,从而发挥治疗作用。

Objective：To discuss effects of enhanced external counterpulsation therapy on progressing stroke to the early atherosclerotic plaque.Method：One hundred and thirty patients with progressive stroke accorded randomly were equally divided into treatment group and control group.Both groups were received conventional medical treatment.On the basis of conventional medical treatment,the treatment group were given the enhanced external counterpulsation therapy.Result：The carotid intima-media thickness（IMT）in the treatment group and the control group was（1.89±0.31）mm and（1.88±0.42）mm before treatment,and（1.18±0.56）mm and（1.45±0.34）mm after treatment respectively.The IMT in the treatment group after treatment was significantly lower than that in the control group（P〈0.05）.After treatment,the plaque burden and plaque area showed significantly downward（P〈0.05）,while the plaque burden and plaque area in the treatment group after treatment were significantly lower than that in the control group（P〈0.05）.The serum levels of P-selectin and fibrinogen after treatment showed significantly downward（P〈0.05）,while the serum P-selectin and fibrinogen levels in the treatment group were significantly lower than those in the control group（P〈0.05）.After treatment,the plaque sclerosis showed hardening trend.Compared with before treatment,there was significant difference（P〈0.05）.While the plaque sclerosis in the treatment group was significantly better than that in the control group after treatment（P〈0.05）.Conclusion：Enhanced external counterpulsation therapy on progressing stroke can effectively play the role of improving coagulation and fibrinolysis,prevent the formation of vulnerable plaque,reduce plaque burden,internal carotid artery plaque area and thickness.