EECP辅助治疗冠心病稳定型心绞痛患者的临床效果及血清炎性因子水平的影响

Clinical effect of EECP assisted in treating patients with stable angina pectoris of coronary heart disease and its influence on the levels of serum inflammatory factors

目的探讨增强型体外反搏(EECP)辅助治疗冠心病稳定型心绞痛患者的临床效果及患者血清炎性因子水平的影响。方法选取2019年3月至2020年3月我院收治的冠心病稳定型心绞痛患者102例为研究对象,采用随机数字法分为常规组和研究组,每组51例。常规组患者给予常规治疗,研究组患者在常规组患者治疗的基础上给予EECP辅助治疗,疗程6周。比较两组患者的临床疗效;比较两组患者治疗前后的心绞痛发作情况(发作频率、持续时间)、心肌缺血总负荷、血管内皮功能以及血清炎性因子水平;比较两组患者治疗后6个月内的心血管不良事件(MACE)发生情况。结果治疗6周,研究组患者的治疗总有效率(96.1%)显著高于常规组(78.4%),差异有统计学意义(P<0.05)。治疗6周后,两组患者的心绞痛发作频率、心绞痛持续时间、心肌缺血总负荷均显著降低(缩短),研究组患者优于常规组,差异有统计学意义(P<0.05)。治疗前,两组患者的内皮依赖性血管舒张功能(FMD)、非内皮依赖性血管舒张功能(NMD)、峰值流速变化率(ΔVpeak)比较,差异无统计学意义(P>0.05);治疗6周后,两组患者的FMD、ΔVpeak均显著升高,研究组患者的水平显著高于常规组(P<0.05);两组患者的NMD比较差异无统计学意义(P>0.05)。治疗前,两组患者的血清补体C1q、补体C1q/肿瘤坏死因子相关蛋白1(CTRP1)水平比较,差异无统计学意义(P>0.05);治疗6周后,两组患者的血清C1q、CTRP1水平均显著降低,研究组患者的水平显著低于常规组,差异有统计学意义(P<0.05)。治疗后6个月内,研究组患者的MACE发生率(3.9%)显著低于常规组(17.7%),差异有统计学意义(P<0.05)。结论在常规治疗的基础上,EECP辅助治疗能显著提高冠心病稳定型心绞痛患者的临床疗效,有效缓解心绞痛发作,改善心肌缺血及血管内皮功能,减轻炎症反应,降低心血管不良事件的发生率。

Objective To explore the clinical effect of enhanced external counterpulsation(EECP)assisted in treating patients with stable angina pectoris of coronary heart disease and its influence on the levels of serum inflammatory factors.Method A total of 102 patients with stable angina pectoris of coronary heart disease admitted to our hospital from March 2019 to March 2020 were selected as the research objects,and they were divided into routine group and research group by the random number method,with 51 cases in each group.Patients in the routine group were given conventional treatment,based on which patients in the study group were received EECP for assisted treatment,for a treatment course of 6 weeks.The clinical efficacy was compared between the two groups.The onset of angina pectoris(frequency and duration),total myocardial ischemic burden,vascular endothelial function and serum inflammatory factors levels before and after treatment were compared between the two groups.The occurrence of major adverse cardiac events(MACE)after 6 months of treatment was compared between the two groups.Results After 6 weeks of treatment,the total effective rate of treatment in the research group(96.1%)was significantly higher than that in the routine group(78.4%),and the difference was statistically significant(P<0.05).After 6 weeks of treatment,the frequency and duration of angina pectoris,and the total myocardial ischemia burden significantly decreased(shortened)in the two groups;compared to the routine group,the research group yielded superior indicators mentioned above,and the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in endothelium-dependent flow-mediated dilation(FMD),endothelial-independent nitroglycerin-induced dilation(NMD),and the change rate of peak flow velocity(ΔVpeak)between the two groups(P>0.05).After 6 weeks of treatment,the FMD andΔVpeak significantly increased,whereas the levels of the research group were significantly higher than those of the routine group(P<0.05).There was no statistically significant difference in NMD between the two groups(P>0.05).Before treatment,there were no statistically significant differences in the serum complement C1q,complement C1q/tumor necrosis factor related protein 1(CTRP1)levels between the two groups(P>0.05).After 6 weeks of treatment,the levels mentioned above significantly decreased in both groups,and the levels of the research group were significantly lower than those of the routine group,with statistically significant differences(P<0.05).The incidence of MACE in the research group(3.9%)was significantly lower than that in the routine group(17.7%)within 6 months after treatment,and the difference was statistically significant(P<0.05).Conclusion On the basis of conventional treatment,EECP assisted to the treatment can significantly improve the clinical efficacy of patients with stable angina pectoris of coronary heart disease,effectively relieve angina pectoris frequency,improve myocardial ischemia and vascular endothelial function,relieve inflammatory responses,and decrease the incidence of MACE.