高压氧治疗在改善无症状冠心病早期心功能减退者血流动力学的作用

目的探讨高压氧治疗在改善无症状冠心病早期心功能减退者血流动力学的作用。方法本研究选取早期无症状冠心病心功能减退患者64例,按照随机数字表法随机分为研究组和对照组,各32例。对照组接受口服单硝酸异山梨酯40 mg,舌下含服复方丹参滴丸10粒治疗,研究组在对照组的基础上加用1次/d的高压氧治疗,比较研究组与对照组的血流动力学参数恢复情况。结果在治疗10 d时,研究组患者的CO、CI、SV、SI、LVSWL、LCWL、VI数值均升高,心功能恢复较快,而对照组则无明显变化,在治疗20 d时,研究组患者的上述血流动力学参数未进一步上升;而对照组的CO、CI、SV、SI、LVSWL、LCWL、VI等血流动力学参数则刚开始升高,这表明单纯扩冠治疗的心脏功能恢复相较于HBO+单纯扩冠治疗的研究组血流动力学参数恢复较晚。在停药60 d后,研究组的血流动力学参数与治疗20 d时的相应参数一致,未发生明显变化,而对照组患者的血流动力学参数则明显下降,且与研究组比较差异有统计学意义(t=3.68、2.98、5.11、4.32、4.25、3.88,P<0.05)。结论在冠心病早期心功能减退的治疗中,高压氧治疗可以使患者的血流动力学改善,值得临床推广使用。

Objective To investigate the effect of hyperbaric oxygen therapy in improving the hemodynamics of early cardiac dysfunction in asymptomatic coronary heart disease. Methods This study in early admitted to no symptoms of coronary heart disease and cardiac functional impairment patients according to the random number table method were randomly divided into study group and control group. The control group received oral administration of 40 mg isosorbide mononitrate, and 10 tablets of Compound Danshen dripping pills. The study group was treated with 1 times/D hyperbaric oxygen therapy on the basis of the control group. Hemodynamic parameters were compared between the two groups. Results In the 10 days of treatment, patients in the study group, CO, CI, SV, SI, LVSWL, LCWL, VI numerical increased, cardiac function recovery faster, while the control group did not change significantly. In the 20 days of treatment, patients in the study group, the hemodynamic parameters did not further increase. While CO, CI, SV, SI LVSWL, LCWL, VI blood dynamics parameters of the control group are just raising. This suggested that only coronary dilatation in treatment of cardiac function recovery later by comparing with the study group （HBO ＋ coronary dilatation treatment）. After discontinuation of 60 d, hemodynamic parameters of the study group and 20 days of treatment when the corresponding parameters consistent, no significant changes, while the control group of patients with hemodynamic parameters decreased significantly by comparing with the study group （t=3.68, 2.98, 5.11, 4.32, 4.25, 3.88, P〈0.05）. Conclusion When treating early cardiac dysfunction in patients with coronary heart disease, hyperbaric oxygen therapy can improve the hemodynamics of the patients. It was worthy of clinical use.