增强型体外反搏治疗进展性卒中对患者动脉血管的影响

The artery effects of enhanced external counterpulsation for the progressive stroke patients

目的探讨增强型体外反搏治疗进展性卒中对患者动脉血管的影响。方法2010年8月至2015年2月选择在我院神经内科诊治的进展性卒中患者92例，根据随机数字表法分为治疗组与对照组各46例，对照组给予常规药物治疗，治疗组在此基础上加用增强型体外反搏治疗。结果所有患者均顺利完成治疗，两组治疗后的CRP与内皮素1（ET-1）值都呈现明显降低的趋势（P〈0．05），同时治疗后治疗组的CRP[（2．09±2．11）mg／L与（8．12±2．46）mg／L，t=15．309]与ET-1值[（13．98±6．30）mg／L与（46．09±11．02）mg／L，t=14．985]均明显低于对照组（P均〈0．05）。治疗组与对照组治疗后的反应性充血后肱动脉内径变化率（FMD）[（11．93±2．13）％与（8．10±1．43）％]、含服硝酸甘油后肱动脉内径变化率（NMD）[（22．98±8．34）％与（16．09±5．12）％]较治疗前[（5．26±1．34）％与（5．27±1．33）％，（13．20±5．33）％与（13．67±4．10）％]明显上升（t值分别为16．934、21．787，8．443、12．345，P均〈0．05），同时治疗后治疗组的FMD与NMD值明显高于对照组（t值分别为7．982、9．113，P均〈0．05）。治疗组治疗后的心踝血管指数与臂踝脉搏波速度明显降低，与治疗前比较差异明显（P均〈0．05），同时与对照组比较差异也有统计学意义（t值分别为4．281、8．456，P均〈0．05）。结论增强型体外反搏治疗进展性卒中能有效抑制内皮素与炎症因子的表达，提高内皮依赖性血管的舒张功能，改善动脉弹性，从而发挥更加有效的治疗作用。

Objective To discuss the artery effects of enhanced external counterpulsation for the progressive stroke patients. Methods Ninety-two progressive stroke patients who were treated in the Fourth People＇s Hospital of Shenzhen from August 2010 to February 2015 were selected and equally divided into the treatment group and the control group based on the random number table. The control group were received conventional therapy, and the treatment group were added treated with enhanced external counterpulsation therapy. Results All patients were successfully completed treatment, the C-reactive protein （CRP） and Endothelin-l（ET-1） were presented decreased significantly after treatment （ P〈 0.05） , and the CRP and ET-1 values in the treatment group were （2.09±2. 11） mg/L, （ 13.98±6. 30） mg/L,significantly lower than those of the control group（（8.12±2.46） mg/L, （46. 09±11.02） mg/L;t = 15. 309,14. 985;P〈0. 05）. After treatment, the FMD and NMD values in the treatment group were significantly increased from （5.26±1.34）% to （ 11.93 ±2. 13）% ,and from （ 13.20±5. 33）% to （22.98±8.34）% ,in the control groupand were from （5. 27±1.33）% to （8. 10±1.43）%,and from （13.67±4. 10）% to （16.09±5.12）%（t= 16.934,21.787,8.443,12. 345;P 〈0. 05 ）, and the value of FMD and NMD in treatment group were significantly higher than in the control group（ t = 7. 982,9. 113;P〈 0. 05 ）. The cardio ankle vascular index （CAVI） and brachial ankle pulse wave velocity （baPWV） values in the treatment group were significantly reduced after treatment, the difference was significant （P〈0. 05）,and compared with the control group the difference was also statistically significant （t = 4.281, 8.456;P〈 0.05 ）. Conclusion Enhanced external counterpulsation for the progressive stroke patients can effectively inhibit the expression of endothelin and inflammatory factors, improve endothelium-dependent relaxation of blood vessels,improve arterial elasticity, and thus play more effective treatment.