增强型体外反搏治疗对老年急性缺血性脑卒中合并冠心病患者的疗效及安全性

Efficacy and safety of enhanced external counterpulsation in elderly patients with acute ischemic stroke complicated by coronary heart disease

目的探讨增强型体外反搏(enhanced external counterpulsation,EECP)治疗对老年急性缺血性脑卒中(acute ischemic stroke,AIS)合并冠心病患者的临床疗效及安全性。方法连续入选2023年1月至6月于秦皇岛市第一医院神经内科住院治疗的AIS合并冠心病患者65例,随机分为对照组32例(药物二级预防)和治疗组33例(药物治疗基础上联合EECP治疗)。比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin量表(mRS)评分及加拿大心血管病学会(CCS)心绞痛分级,记录2组治疗期间再发AIS、新发出血性脑卒中及主要不良心血管事件(major adverse cardiovascular events,MACE)。结果2组治疗后NIHSS评分、mRS评分均较治疗前下降(P<0.01);治疗组治疗后NIHSS评分、mRS评分、CCS心绞痛分级低于对照组[(2.67±1.63)分vs(3.56±1.83)分,1.0(0.0,1.0)分vs 2.0(1.0,2.0)分,1.0(1.0,2.0)级vs 2.0(1.0,2.0)级,P<0.05,P<0.01]。对照组和治疗组治疗期间再发AIS、新发出血性脑卒中及MACE比较无显著差异(9.4%vs 6.1%,6.3%vs 3.0%,12.5%vs 6.1%,P>0.05)。结论EECP治疗对于老年AIS合并冠心病患者安全有效。

Objective To explore the efficacy and safety of enhanced external counterpulsation(EECP)in elderly patients with acute ischemic stroke(AIS)complicated by coronary heart disease(CHD).Methods A total of 65 AIS patients with CHD admitted in our hospital from January to June 2023 were recruited and randomly divided into a control group(drug secondary prevention,n=32)and a treatment group(drug combined with EECP therapy,n=33).Their NIHSS score,mRS score and Canadian Cardiovascular Society(CCS)angina grade were evaluated before and after treatment and compared between the two groups.The incidences of recurrent ischemic stroke,new hemorrhagic stroke and major adverse cardiovascular events(MACE)were also recorded during treatment.Results The NIHSS score and mRS score were significantly decreased in both groups after treatment(P<0.01).After treatment,the NIHSS score(2.67±1.63 vs 3.56±1.83),mRS score[1.0(0.0,1.0)vs 2.0(1.0,2.0)]and CCS grade[1.0(1.0,2.0)vs 2.0(1.0,2.0)]were obviously lower in the treatment group than the control group(P<0.05,P<0.01).There were no statistical differences in the incidence rates of recurrent ischemic stroke,new-onset hemorrhagic stroke,and MACE between the control group and the treatment group(9.4%vs 6.1%,6.3%vs 3.0%,12.5%vs 6.1%,P>0.05).Conclusion EECP is a safe and effective treatment option for elderly AIS patients with CHD.