增强型体外反搏装置治疗老年2型糖尿病合并下肢动脉粥样硬化性病变的疗效观察  

Effect of enhanced external counterpulsation on elderly patients with lower extremity atherosclerotic disease induced by type 2 diabetes mellitus

作　　者：权乾坤[1] 李玺[1] 袁海峰[2] 张冰玮 QUAN Qian-kun;LI Xi;ZHANG Bing-wei;YUAN Hai-feng(Department of Rehabilitation,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]西安交通大学第二附属医院老年病科,陕西省西安市710004 [2]西安交通大学第二附属医院康复科,陕西省西安市710004

出　　处：《实用老年医学》2020年第12期1270-1274,共5页Practical Geriatrics

基　　金：国家重点研发计划项目资助(2020YFC2004400)。

摘　　要：目的探讨增强型体外反搏装置(enhanced external counterpulsation,EECP)对老年T2DM合并下肢动脉粥样硬化性病变(lower extremity atherosclerotic disease,LEAD)的临床疗效。方法将老年T2DM合并LEAD病人随机分为常规治疗组和EECP组,每组各20例。常规治疗组给予一级预防及抗PLT、调脂、控制血糖、扩张血管等治疗,EECP组在上述常规治疗基础上加用EECP治疗。治疗前及治疗35 d后评价病人的症状、体征改善情况;采用彩色多普勒超声测得病人的静息踝肱指数(ankle brachial index,ABI)、下肢动脉搏动指数(pulse index,PI)及收缩期峰值流速(peak systolic velocity,PSV),采用经皮氧分压监测仪检测病人下肢经皮氧分压(transcutaneous oxygen pressure,TcPO2),从而评价病人下肢动脉循环与血供改善情况。结果与治疗前相比,EECP组治疗后下肢皮温、麻木、疼痛、皮肤色泽、肌肤营养状态、足背动脉搏动情况均得到明显改善(P<0.05),常规治疗组仅皮温、肌肤营养状态得到明显改善(P<0.05),且EECP组治疗后下肢麻木、疼痛、皮肤色泽、肌肤营养状态、足背动脉搏动均较常规治疗组改善明显(P<0.05)。治疗后,EECP组双侧下肢动脉的ABI、PSV、TcPO2水平均较治疗前有所提高(P<0.05),PI水平降低(P<0.05);且EECP组病人上述指标均较常规治疗组改善明显(P<0.05)。结论EECP可以有效改善老年T2DM合并LEAD病人的症状和体征,改善下肢动脉循环与血供。Objective To investigate the curative effect of enhanced external counterpulsation(EECP)on the elderly patients with lower extremity atherosclerotic disease(LEAD)induced by type 2 diabetes mellitus(T2DM).Methods The elderly patients with LEAD induced by T2DM were randomly divided into conventional treatment group and EECP group,with 20 cases in each group.The conventional treatment group was treated with primary prevention,antiplatelet,lipid regulation,blood glucose control and vasodilation,whereas EECP group received EECP treatment in addition to the conventional treatment.After 35 days of intervention,the symptoms and signs of the patients were examined.Furthermore,the artery circulation and blood supply of lower extremity arteries were evaluated by measuring ankle brachial index(ABI),pulse index(PI)and peak systolic velocity(PSV)using color Doppler ultrasound and by detecting transcutaneous oxygen pressure(TcPO2)using TcPO2 monitor.Results After treatment,the skin temperature,numbness,pain,skin color,skin nutrition and pulsation of dorsalis pedis artery of the lower extremities in EECP group were significantly improved(P<0.05),while only skin temperature and skin nutrition of the lower extremities in conventional treatment group were significantly improved(P<0.05);The numbness,pain,skin color,skin nutrition and pulsation of dorsalis pedis artery of the lower extremities in EECP group were significantly better than those in conventional group(P<0.05).Compared with those before treatment,the levels of ABI,PSV and TcPO2 of lower extremity arteries were increased,and the level of PI was decreased in EECP group after treatment(all P<0.05);In addition,the above indexes levels in EECP group were better than those in conventional treatment group(all P<0.05).Conclusions EECP could effectively improve the symptoms,signs,artery circulation and blood supply of lower extremity arteries in the elderly patients with LEAD induced by T2DM.

关 键 词：增强型体外反搏装置 2型糖尿病 下肢动脉粥样硬化性病变 疗效 

分 类 号：R587.1[医药卫生—内分泌] R543.5[医药卫生—内科学]