体外反搏改善缺血性心力衰竭患者疗效及无创心功能检测指标

External counterpulsation improves curative effect in patients with ischemic heart failure and noninvasive heart function detection indexes

目的研究体外反搏对缺血性心力衰竭患者缺血症状、心功能、心力衰竭标志物的治疗效果。方法将180例缺血性心力衰竭患者分为体外反搏组和对照组。治疗组接受体外反搏治疗,观察两组治疗后心绞痛疗效、心功能(超声心动图、无创血流动力学监测、NYHA心功能分级)、心力衰竭标志物的变化。结果反搏组心绞痛治疗有效率高于对照组,差异有统计学意义(P<0.01)。反搏组心输出量(CO)和心脏指数(CI)明显高于对照组,差异有统计学意义(P<0.01);反搏组每搏输出量(SV)、每搏指数(SI)、加速度指数(ACI)和速度指数(VI)均高于对照组,差异均有统计学意义(P<0.05);而体血管阻力(SVR)、体血管阻力指数(SVRI)和收缩时间比率(STR)低于对照组,差异均有统计学意义(P<0.05);两组左室射血分数(EF)、左室舒张末内径(LVEDd)和胸腔液体容积(TFC)差异无统计学意义(P>0.05);两组治疗前美国纽约心脏病学会(NYHA)心功能分级差异无统计学意义(P>0.05),治疗后反搏组NYHA心功能分级较对照组改善(P<0.05)。两组治疗前NT-proBNP差异无统计学意义(P>0.05),治疗后反搏组NT-proBNP显著低于对照组,差异有统计学意义(P<0.01)。结论体外反搏可用于缺血性心力衰竭患者的治疗,缓解心绞痛症状,改善心功能及心力衰竭标志物。

Objective To study the curative effect of enhanced external counterpulsation（EECP） on the ischemic symptoms, heart function and heart failure markers in the patients with ischemic heart failure. Methods One hundred and eithty patients with ischemic heart failure were divided into the external counterpulsation group and the control group. The treatment group received the EEGP therapy. The angina curative effect and heart function（ultrasonic echocardiography, noninvasive hemodynamic monitoring, NYHA heart function grade） as well as heart failure markers changes after treatment were observed in the two groups. Results The effective rate of angina treatment in the counterpulsation group was higher than that in the control group, the difference was statistically significant （P〈0.01）. The cardiac output （CO） and cardiac index （CI） in the counterpulsation group were significantly higher than those in the control group, the difference was statistically significant （P〈0. 01） ;the stroke volume （SV）, stroke vol- ume index （SI） ,acceleration index （ACI） and velocity index （VI） in the counterpulsation group were higher than those in the con- trol group, the difference was statistically significant （P〈0.05） ;the systemic circulation peripheral vascular resistance （SVR）, sys- temic circulation peripheral vascular resistance index （SVRI） and systolic time rate （STR） in the counterpulsation group were lower than those in the control group,the difference was statistically significant （P〈0.05）. There were no statistical difference between the two groups in left ventricular ejection fraction（EF）,left ventricular end diastolic diameter（LVEDd） and thoracic cavity fluid volume（TFC） （P〉0.05）;there was no statistical difference in NYHA heart function grade between the two groups before treat- ment. The NYHA heart function grade after treatment in the counterpulsation group was improved compared with that in the con- trol group （P〈0.05）. There was no statistical difference in NT-proBNP before treatment between the two groups. The NT-proB- NP level after treatment in the counterpulsation group was significantly lower than that in the control group, the difference was sta- tistically sinificant（P〈0.01）. Conclusion External counterpulsation can be used for the treatment in the patients with ischemic heart failure, can alleviate the angina symptoms, improves the heart function and heart failure markers.