体外反搏治疗慢性老年性心力衰竭临床研究

Clinical Study on External Counterpulsation in Treatment of Senile Patients with Chronic Heart Failure

目的研究体外反搏治疗对老年人慢性心衰心脏超声心功能指标及氨基末端B型脑钠肽前体(NT-proBNP)浓度变化的影响。方法方便选取2016年10月—2017年12月期间于该院住院的102例老年慢性心衰患者,随机分为两组:对照组(51例)给予常规抗心力衰竭治疗;治疗组(51例)在对照组治疗基础上加用体外反搏治疗。比较两组患者治疗前后临床疗效、左室舒张末期内径(LVDD)、左室射血分数(LVEF)和NT-proBNP浓度变化。结果治疗组治疗后总有效率(88.24%)明显高于对照组(64.71%),差异有统计学意义(P<0.05);治疗前后对比,对照组LVDD差值为(2.93±7.11)mm、LVEF差值为(4.73±4.39)%,治疗组LVDD差值为(6.26±3.23)mm、LVEF差值为(7.18±3.52)%,治疗组比对照组心功能指标改善更为明显,差异有统计学意义(P<0.01);治疗后对照组NT-proBNP浓度(1 674±657)pg/L与治疗组NT-proBNP浓度(1 028±400)pg/L均下降,治疗组下降更为明显,差异有统计学意义(P<0.01)。结论常规抗心衰基础上加用体外反搏治疗老年性慢性心衰患者能提高治疗有效率,改善心功能,降低血浆NT-proBNP水平。

Objective To research the effect of external counterpulsation on the cardiac index and changes of NT-proBNP concentration of senile patients with chronic heart failure. Methods 102 cases of senile patients with chronic heart failure admitted and treated in our hospital from October 2016 to December 2017 were selected and randomly divided into two groups with 51 cases in each, the control group used the routine anti-heart failure drugs, while the treatment group were treated with external counterpulsation on the basis of the control group, and the clinical curative effect and changes of LVDD, LVEF and NT-proBNP concentrations were compared between the two groups. Results The total treatment effective rate in the treatment group was obviously higher than that in the control group（88.24% vs 64.71%）, and the difference was obvious（P〈0.05）, and the LVDD different value and LVEF difference value in the control group and in the treatment group were respectively（2.93±7.11）mm,（4.73±4.39）% and（6.26±3.23）mm,（7.18±3.52）%, and the improvement of cardiac function index in the treatment group were more obvious than that in the control group, and the difference was obvious（P〈0.01）,after treatment, the NT-proBNP concentration in the control group and in the treatment group decreased, which was（1 674±657）pg/L and（1 028±400）pg/L, and the decrease in the treatment group was more obvious, and the difference was statically significant（P〈0.01）. Conclusion The routine anti-heart failure and external counterpulsation in treatment of senile patients with chronic heart failure can improve the treatment effective rate, improve the cardiac function and reduce the blood plasma NT-proBNP level.