通心络联合增强型体外反搏对冠心病心绞痛患者血管内皮功能、心肌灌注水平和心功能的影响

Effects of Tongxinluo combined with enhanced external counterpulsation on vascular endothelial function,myocardial perfusion level and cardiac function in patients with coronary heart disease and angina pectoris

目的探究通心络联合增强型体外反搏(EECP)对冠心病心绞痛患者血管内皮功能、心肌灌注水平和心功能的影响。方法将118例冠心病心绞痛患者依照随机对照原则分为EECP组和联合组,各59例。EECP组在常规对症处理基础上接受EECP治疗,联合组在EECP组治疗基础上加服通心络胶囊。比较两组的心绞痛发作持续时间及频率、血流动力学指标、血管内皮功能指标、心肌灌注水平、心功能指标及心功能改善情况。结果治疗后,两组的心绞痛发作持续时间均短于治疗前,频率均低于治疗前,且联合组优于EECP组(P<0.05)。治疗后,两组的全血高切黏度、全血低切黏度、红细胞聚集指数、血小板聚集率均小于治疗前,且联合组小于EECP组(P<0.05)。治疗后,两组的反应性充血指数(RHI)、6-酮前列腺素F1α(6-Keto-PGF1α)、一氧化氮(NO)水平均高于治疗前,内皮素-1(ET-1)水平均低于治疗前,且联合组优于EECP组(P<0.05)。治疗后,两组的放射性缺损面积小于治疗前,放射性分布异常评分低于治疗前,且联合组优于EECP组(P<0.05)。治疗后,两组的心脏指数(CI)、左室射血分数(LVEF)均大于治疗前,且联合组大于EECP组(P<0.05)。治疗后,联合组的心功能改善情况优于EECP组(P<0.05)。结论通心络联合EECP治疗冠心病心绞痛的效果显著,能有效改善血流动力学和血管内皮功能,缩小心肌缺血面积,增强心功能。

Objective To investigate the effects of Tongxinluo combined with enhanced external counterpulsation(EECP)on vascular endothelial function,myocardial perfusion level and cardiac function in patients with coronary heart disease and angina pectoris.Methods A total of 118 patients with coronary heart disease and angina pectoris were divided into EECP group and combined group according to the randomized control principle,with 59 cases in each group.The EECP group received EECP treatment on the basis of conventional symptomatic treatment,and the combined group was treated with Tongxinluo capsule on the basis of the EECP group.The duration and frequency of angina pectoris attack,hemodynamic indexes,vascular endothelial function indexes,myocardial perfusion levels,cardiac function indexes and the improvement of cardiac function were compared between the two groups.Results After treatment,the duration of angina pectoris attack in the two groups was shorter than that before treatment,the frequency was lower than that before treatment,and those in the combined group were better than the EECP group(P<0.05).After treatment,the whole blood high shear viscosity,whole blood low shear viscosity,erythrocyte aggregation index and platelet aggregation rate in the two groups were smaller than those before treatment,and those in the combined group were smaller than the EECP group(P<0.05).After treatment,the levels of reactive hyperemia index(RHI),6-keto-prostaglandin F1α(6-Keto-PGF1α)and nitric oxide(NO)in the two groups were higher than those before treatment,the level of endothelin-1(ET-1)was lower than that before treatment,and those in the combined group were better than the EECP group(P<0.05).After treatment,the radioactive defect area of the two groups was smaller than that before treatment,the radioactive distribution abnormal score was lower than that before treatment,and those in the combined group were better than the EECP group(P<0.05).After treatment,the cardiac index(CI)and left ventricular ejection fraction(LVEF)in the two groups were greater than those before treatment,and those in the combined group were greater than the EECP group(P<0.05).After treatment,the improvement of cardiac function in the combined group was better than that in the EECP group(P<0.05).Conclusion Tongxinluo combined with EECP in the treatment of coronary heart disease and angina pectoris has a significant effect,which can effectively improve the hemodynamics and vascular endothelial function,reduce the area of myocardial ischemia and enhance the cardiac function.