增强型体外反搏对老年高血压患者血压的即刻作用和持续影响  

Immediate and lasting effects of enhanced external counterpulsation on blood pressure in elderly patients with hypertension

作　　者：张丹丹 王少华 马娟[1] 赵韶华[1,3] 陈晓明 孙延凯[1] 田菲菲 胡艳艳 王媛媛[1,3] 王伟玲 张珍[1,3] 沈琳 Zhang Dandan;Wang Shaohua;Mu Juan;Zhao Shaohua;Chen Xiaoming;Su Yunkai;Tian Feifei;Hu Yanyan;Wang Yuanyuan;Wang Weiling;Zhang Zhen;Shen Lin(Department of Geriatric Medicine.Qilu Hospital of Shundong University,Jinun 250012.China;Department of Cardiorusculur Medicine.Jinan Hospilal.Jinan.250013,China;Depurtment of Grerialric Medicine,Qilu Hospital of Shundong University,Shandong provincial Key Laboralory of Cardioruscular Proteomics.Jinan 250012)

机构地区：[1]山东大学齐鲁医院老年医学科,250012 [2]济南医院心血管内科,250013 [3]山东省心血管疾病蛋白质组学重点实验室,济南250012

出　　处：《中华老年医学杂志》2021年第12期1512-1516,共5页Chinese Journal of Geriatrics

基　　金：山东省重点研发计划(2017GSF218012,2018GSF118194,2017GSF218101)。

摘　　要：目的探讨增强型体外反搏(EECP)对老年高血压患者血压的即刻作用和持续影响。方法前瞻性病例对照研究。连续性纳入2019年5月至12月在山东大学齐鲁医院老年科初诊或既往血压控制不佳的老年高血压患者.排除收缩压≥180 mmHg(1mmHg=0.133kPa)及有EECP治疗禁忌证患者28例为EECP组,依据倾向评分匹配法按照1:1比例选择基线资料、并存疾病、心血管用药及EECP组疗程开始前3d血压匹配的对照组患者28例。EECP组患者在改善生活方式和降压药物等标准治疗基础上接受为期6周36h的EECP治疗。EECP组患者治疗前3min.治疗中第30 min和治疗后3 min分别采集卧位血压。EECP组患者在6周疗程开始前3 d.疗程第6周和疗程结束后第2周、第4周和第12周分别采集家庭自测血压.对照组患者在上述同-时间点采集家庭自测血压。比较EECP组与对照组血压的差异及影响因素。结果与治疗前3 min比较.EECP患者治疗第30 min收缩压下降(5.5±13.6)mmHg(P<0.01).即刻舒张压下降(1.1±7.5)mmHg(P<0.01)。基线收缩压160~169 mmHg时,治疗中升高的概率为2.2%(2/89).170~179 mmHg时为0%(0/57)。疗程第6周时.EECP组患者收缩压下降幅度大于对照组.(-17.0±8.7)mmHg比(-10.5±7.3)mmHg(P<0.01);疗程结束后第2周和第4周时,EECP组患者收缩压下降幅度亦大于对照组.(-15.5±6.6)mmHg比(-10.6±2.5)mmHg(P<0.01).(-13.3±5.4)mmHg(-10.7±2.1)mmHg(P<0.05);疗程结束后第12周时.血压下降幅度大于对照组,但差异无统计学意义(P>0.05)。吸烟史.糖尿病史,高血压家族史及并发症的改善情况是影响EECP持续降压效果的因素。结论EECP治疗对老年高血压患者具有即刻降压作用.6周疗程的EECP治疗具有持续的降压效应。该效应可持续至疗程结束后4~12周。Objective To investigate the immediate and lasting efects of enhanced external counterpulsation(EECP)on blood pressure in elderly patients with bypertension.Methods In this real-world prospective non randomized controlled study.the elderly hypertensive patients who were newly diagnosed as hypertension or had poor blood pressure control in the Geriatrics Depariment of Shandong University Qilu Hospital from May 2019 to December 2019.were enrolled as EECP group.and those with systolic blood pressure(SBP)≥180mmHg(1mmHg=0.133 kPa)or had contraindications for EECP treatment were excluded from EECP group(28 cases).Based on the 1:1 ratio being consistent with the tendency score matching method.patients'blood pressure was matched at3 d before the start of the EECP treatment course.with other matched data of baseline data.coexisting disease.cardiovascular medication were choosed as control group(n=28).The EECP group received an additional 36 hours of EECP treatment(6 times/week,1 hour/time)including lifestyle improvement and anti-hypertensive drugs.The patient's supine blood pressure was ollcted 3 minutes before each EECP treatment(baseline),30 minutes during treatment.and 3 minutes after treatment.In the EECP group.family self measured blood pressure was ollected 3 days before the start of the 6-week treament course(0w),the 6th week(6w)of the treatment course,and the 2nd week(+2w).4th week(+4w)and 12th week(+12w)after the end of the treatment course.respectively.And the data of control group were collected at the same time point mentioned above.Results Compared with baseline.the average immediate SBP of elderly hypertensive patients at the 30th minute of EECP treatment was decreased by(5.5±13.6)mmHg(P<0.001) and the average immediate diabolic blood pressure(DBP)was decreased by(1.1±7.5)mmHg(P<0.001).When the baseline SBP was between 160 and 169 mmHg,the probability of a further increase in SBP during treatment was 2.2%(2/89 cases),and when the baseline SBP was between 170 and 179 mmHg,the probability of a further incr

关 键 词：高血压 增强型体外反搏 

分 类 号：R544.1[医药卫生—心血管疾病]