体外反搏对平板运动试验阳性的稳定型心绞痛患者运动耐量和心功能的影响

Effects of external counter-pulsation on exercise capacity and ventricular function in patients with stable angina and positive treadmill test

目的观察体外反搏对平板运动试验阳性的稳定型心绞痛患者运动耐量和心功能的影响。方法将2011年3月~2013年9月就诊于武汉大学中南医院心内科的68例冠状动脉粥样硬化性心脏病（冠心病）稳定型心绞痛患者随机分为两组，常规治疗组（常规药物治疗，n=34)和体外反搏组（在常规药物基础上加用体外反搏治疗，n=34);治疗前后进行平板运动试验和超声心动图检测，对两组患者的运动耐量和心功能相关指标对比观察。结果治疗6周后，两组患者ST段最大下移幅度均减小，运动总时间延长，做工量增加，射血分数（EF)升高，左室舒张末期内径（LVDD)减小，与治疗前比差异有统计学意义（P<0.05);两组相比，体外反搏组治疗前后射血分数、左室舒张末期内径的变化更为明显（P<0.05)，舒张功能指标（舒张早期运动速度Ea、舒张晚期运动速度Aa、Ea/Aa)在体外反搏组得到明显改善，而在常规治疗组变化则不明显（P>0.05)。结论联合体外反搏治疗稳定型心绞痛优于单纯药物治疗，尤其是能改善冠心病患者心脏舒张功能，提高运动耐量，从而改善患者的生活质量。

Objective To observe the efficacy of external counter-pulsation(ECP)on exercise capacity andventricular function in patients with stable angina and positive treadm ill test.Methods The68chronic stableangina patients with positive treadmill test were randomly assigned to the routine treatm ent group(n=34)and theexternal counter-pulsation treatm ent group(n=34)based on whether being received routine treatment.The treadmilltest and ultrasound cardiogram were made before and after treatm ent to analyze the param eter changes in theexaminations.Results After six-week treatment,the maximum depth of ST segment depression were significantlydim inished,total exercise times and exercise work were significantly increased,and the left ventricular systolicfunction(EF|,LVDD|)were also significantly improved in two groups(P<0.05).But those param eters werechanged more significantly(P<0.05)in the external counter-pulsation treatm ent group than in the routine group.The left ventricular diastolic function parameters(E a|、A a|、Ea/A a|)were also improved(all P<0.05)in theECP group,but there was no obvious difference in routine group before and after treatment(P>0.05).ConclusionsThe external counter-pulsation is superior to drug therapy alone in treating chronic stable angina,which couldimprove exercise tolerance and ventricular function in patients.