体外反搏治疗心脏X综合征的临床疗效研究

Clinical Efficacy of Enhanced External Counterpulsation on Cardiac Syndrome X

目的观察体外反搏(EECP)治疗心脏X综合征(CSX)的近期临床疗效,为CSX的治疗提供理论依据。方法选取2014年1月—2015年6月在郑州大学第二附属医院心内科住院的由经皮冠状动脉造影术(CAG)确诊且符合纳入与排除标准的CSX患者120例为研究对象。采用随机数字表法分为反搏组(60例)和对照组(60例)。对照组给予常规药物治疗,反搏组在常规药物治疗基础上加用EECP治疗。收集患者一般资料,比较患者EECP治疗前1周及出院后1周心绞痛发作次数、静息心电图,入院时及治疗结束时运动耐量(包括运动总时间及开始运动至ST段下降1 mm时间)。结果两组患者治疗前心绞痛发作次数比较,差异无统计学意义(P>0.05);反搏组患者治疗后心绞痛发作次数少于对照组(P<0.05);反搏组患者治疗后心绞痛发作次数少于治疗前(P<0.05)。反搏组患者总有效率大于对照组(P<0.05)。两组患者入院时运动总时间、开始运动至ST段下降1 mm时间比较,差异无统计学意义(P>0.05);反搏组患者治疗结束时运动总时间、开始运动至ST段下降1 mm时间长于对照组(P<0.05);对照组患者治疗结束时运动总时间长于入院时(P<0.05);反搏组患者治疗结束时运动总时间、开始运动至ST段下降1 mm时间长于入院时(P<0.05)。结论 EECP是治疗CSX的有效方法,值得临床推广应用。

Objective To observe the short - term clinical efficacy of enhanced external counterpulsation（EECP）on cardiac syndrome X（CSX）and provide theoretical basis for the treatment of CSX. Methods From January 2014 to June 2015, we enrolled 120 inpatients who were diagnosed with CSX and accorded with inclusion and exclusion criteria from the Department of Cardiology of the Second Affiliated Hospital of Zhengzhou University. Using random number table method,we divided patients into EECP group（n = 60）and control group（n = 60）. The control group was given conventional treatment,and the EECP group was given EECP on the basis of conventional treatment. The general data of patients were collected. Comparison was made in the times of angina attack and resting electrocardiogram between the two groups one week before treatment and one week after discharge,and comparison was also made in exercise capacity（including total exercise time and time from the start of exercise to 1 mm decrease of ST segment）between the two groups at admission and when treatment ended. Results The two groups were not significantly different in the times of angina attack before treatment between the two groups（P 〉 0. 05）;the EECP group had less times of angina attack than control group after treatment（ P 〈 0. 05）. The EECP group had less times of angina attack after treatment than those before treatment（P 〈 0. 05）. The EECP group had higher overall efficiency than that of the control group （P 〈 0. 05）. The two groups were not significantly different in total exercise time and time from the start of exercise to 1 mm decrease of ST segment at admission（P 〉 0. 05）;the EECP group had longer total exercise time and longer time from the start of exercise to 1 mm decrease of ST segment than those of control group when treatment ended（P 〈 0. 05）. The control group had longer total exercise time when treatment ended than that at admission（P 〈 0. 05）;the EECP group had longer total exercise time and longer time from the start of exercise to 1 mm decrease of ST segment when treatment ended than those at admission（P〈 0. 05）. Conclusion EECP is an effective method for CSX and is worth being promoted in clinical practice.