增强型体外反搏对不稳定型心绞痛患者经皮冠状动脉介入治疗后血流的短期效应与安全性  

Short-term effect and safety of enhanced external counterpulsation on coronary flow after percutaneous coronary intervention in patients with unstable angina pectoris

作　　者：孙刚[1] 吴宇红[1] 张学芳[1] 谭文锋[1] 张高星[1] SUN Gang;WU Yu-hong;ZHANG Xue-fang;TAN Wen-feng;ZHANG Gao-xing(Department of Cardiology,Jiangmen Central Hospital,Jiangmen,Guangdong 529030,China)

机构地区：[1]江门市中心医院心内科,广东江门529030

出　　处：《岭南心血管病杂志》2018年第1期9-13,共5页South China Journal of Cardiovascular Diseases

基　　金：项目由广东省社会发展领域科技计划项目资助(项目编号:2012A03220005)

摘　　要：目的探讨增强型体外反搏(enhanced external counterpulsation,EECP)对冠状动脉粥样硬化性心脏病(冠心病)不稳定型心绞痛患者经皮冠状动脉介入治疗后血流的短期效应与安全性。方法连续收集江门市中心医院诊断为冠心病不稳定型心绞痛并经桡动脉行冠状动脉支架植入术的患者120例,按随机数字表法分为EECP组和对照组,每组各60例。EECP组在支架植入术后给予EECP治疗,持续时间为30 min;而对照组在支架植入术后给予气囊包裹但不进行反搏治疗,持续时间为30 min。记录两组患者支架植入术后即刻与30 min后的中心主动脉舒张压、校正的心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)帧数(corrected TIMI frame count,cTFC)和心率;同时记录两组患者在支架植入术后EECP治疗或气囊包裹过程中出现的不良反应与并发症。结果在EECP组,支架植入术后即刻和30 min后中心主动脉舒张压分别为(71.0±8.7)mmHg(1 mmHg=0.133 kPa)和(81.2±9.1)mmHg,差异有统计学意义(P<0.05);cTFC分别为(35.2±17.7)帧和(21.9±3.1)帧,差异有统计学意义(P<0.05);心率分别为(73.2±10.1)次/min和(73.6±10.1)次/min,差异无统计学意义(P>0.05)。在对照组,支架植入术后即刻和30 min后中心主动脉舒张压分别为(72.9±8.8)mm Hg和(74.1±8.6)mm Hg,差异无统计学意义(P>0.05);c TFC分别为(37.8±18.8)帧和(37.0±18.6)帧,差异无统计学意义(P>0.05);心率分别为(74.8±9.2)次/min和(74.9±9.3)次/min,差异无统计学意义(P>0.05)。在安全性方面,EECP治疗过程中有患者抱怨气囊不适、噪音影响等不良反应,但无出血、脑卒中、再次心肌梗死、死亡等主要不良心血管事件的发生。结论 EECP对不稳定型心绞痛患者经皮冠状动脉介入治疗后短期的血流动力学有明显的改善作用,能够有效减少慢血流的发生,而没有增加不良事件的发生,是一项安全而有效的治疗手段。To observe the short-term effect and safety of enhanced external counterpulsation(EECP)on coronary flow after percutaneous coronary intervention in patients with unstable angina pectoris.Methods A total of120patients with unstable angina pectoris,who underwent coronary artery stent implantation via radial artery,were ran?domly divided into EECP group and control group,with60patients in each group.Both groups were accepted the rou?tine treatment of coronary artery disease.In EECP group,the patients were treated with EECP for30min after coronary artery stent implantation;and in control group,the patients were given cuffs wrapped without EECP treatment,and du?ration was30min.Central arotadiastolic blood pressure,corrected thrombolysis in myocardial infarction(TIMI)frame count(cTFC)and heart rate of immediate and after a30-min delay after stent implantation were recorded.Meanwhile,adverse reactions and complications during treatment were recorded.Results In EECP group,central arota diastolic blood pressure of immediate and after a30-min delay after stent implantation were(71.0±8.7)mmHg(1mmHg=0.133kPa)and(81.2±9.1)mmHg,in which there was significant difference(P<0.05);cTFC were(35.2±17.7)frame and(21.9±3.1)frame,in which there was significant difference(P<0.05),and heart rate were(73.2±10.1)beat/min and(73.6±10.1)beat/min,in which there was no significant difference(P>0.05).In control group,central arota diastolic blood pressure of immediate and after a30-min delay after implantation were(72.9±8.8)mmHg and(74.1±8.6)mmHg,in which there was no significant difference(P>0.05);cTFC were(37.8±18.8)frame and(37.0±18.6)frame,in which there was no significant difference(P>0.05);heart rate were(74.8±9.2)beat/min and(74.9±9.3)beat/min,in which there was no significant difference(P>0.05).In the aspcet of safety,there were patients complaining about tight cuffs and noise effect,but there was no major adverse cardiac event(MACE),such as bleeding,stroke,reinfarction and death.Conclusions EECP could improve the short-term

关 键 词：冠状动脉疾病 支架植入术 增强型体外反搏 慢血流 

分 类 号：R541.4[医药卫生—心血管疾病]