体外反搏联合尼可地尔治疗冠脉微循环障碍临床观察

Clinical Observation of External Counter-Pulsation Combined With Nicorandil in the Treatment of Coronary Microvascular Dysfunction

目的:探讨体外反搏(ECP)联合尼可地尔对冠脉微循环障碍患者的影响。方法:选取冠脉微循环障碍患者87例,随机分为观察组(44例)和对照组(43例)。对照组行传统西药加尼可地尔治疗,观察组在此基础上予以ECP联合治疗。观察比较2组患者治疗效果、运动耐力指标[单次运动持续时间、运动耐力、最大耗氧量(VO_(2)peak)、ST段下移幅度]、血流动力学指标[基础血流量、局部心肌血流量(MBF)、TIMI血流帧数平均值、血浆比黏度]、C-反应蛋白(CRP)表达水平。结果:观察组临床疗效(95.50%)高于对照组(79.10%),差异有统计学意义(P<0.05);2组治疗后单次运动持续时间、运动耐力、VO_(2)peak均有提升,且观察组提升程度大于对照组,2组ST段下移幅度均有下降,且观察组下降程度[(0.08±0.03) mV]大于对照组[(0.14±0.04) mV],差异均有统计学意义(P<0.05);2组治疗后基础血流量、MBF均有所升高,且观察组MBF[(29.57±4.86) dB2·s^(-1)]明显高于对照组[(24.71±4.62) dB2·s^(-1)],TIMI血流帧数、血浆比黏度有所下降,且观察组TIMI血流帧数[(25.34±4.51)帧]明显低于对照组[(29.37±5.07)帧],差异均有统计学意义(P<0.05)。结论:体外反搏联合尼可地尔治疗冠脉微循环障碍可提高临床疗效,显著改善患者运动耐力和血流动力学。

Objective:To analyze the efficacy of external counter-pulsation(ECP)combined with nicorandil in the treatment of coronary microvascular dysfunction.Methods:A total of 87 patients with coronary microvascular dysfunction were randomly divided into the control group(43 cases)and the study group(44 cases).The control group was treated with traditional Western medicine plus nicorandil,and the study group was treated with External counter-pulsation.The therapeutic effect,exercise endur-ance index[duration of a single exercise,exercise endurance,maximum oxygen consumption(VO2peak),ST segment down-shift amplitude],hemodynamic index[basic blood flow,local myocardial blood flow(MBF),average TIMI flow frame number,plasma specific viscosity]and CRP expression level of the two groups were observed and compared.Results:Compared with the control group,the clinical treatment of the study group was significantly better(95.50%vs 79.10%),with a statistically signifi-cant difference(P<0.05).After treatment,the single exercise duration,exercise endurance,and VO_(2)peak of both groups of pa-tients were improved,and the degree of improvement in the study group was greater than that in the control group METs,with a statistically significant difference(P<0.05).After treatment,both groups showed a decrease in the magnitude of ST segment descent,and the degree of decline in the study group was greater than that in the control group,with a statistically significant difference(P<0.05).After treatment,both groups of patients showed an increase in basal blood flow and MBF,while the study group showed a more significant increase in MBF(P<0.05).Compared with the control group,the study group had significantly lower TIMI blood flow frames after treatment,with a statistically significant difference(P<0.05).Conclusion:ECP combined with nicorandil in the treatment of coronary microvascular dysfunction can improve clinical efficacy,and significantly improve exercise endurance and hemodynamics.