增强型体外反搏治疗急性心肌梗塞的疗效及其对肾素-血管紧张素-醛固酮系统的影响  

Efficacy of enhanced external counterpulsation in the treatment of AMI and its influence on RAAS system

作　　者：张双[1] 刘淑华[1] 刘立杰[2] 刘晓静 刘永政[3] ZHANG Shuang;LIU Shu-hua;LIU Li-jie;LIU Xiao-jing;LIU Yong-zheng(Department of Cardiovascular Medicine,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China;Department of Oncology Radiotherapy,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China;First Department of Cardiology,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院心血管内科,河北秦皇岛066000 [2]秦皇岛市第一医院肿瘤放射治疗科,河北秦皇岛066000 [3]秦皇岛市第一医院心内一科,河北秦皇岛066000

出　　处：《川北医学院学报》2022年第1期39-42,共4页Journal of North Sichuan Medical College

基　　金：河北省秦皇岛市科学技术研究与发展计划项目(201902A058)。

摘　　要：目的:探究增强型体外反博治疗(EECP)对急性心肌梗塞(AMI)患者心功能及肾素-血管紧张素-醛固酮系统(RAAS)的影响。方法:根据治疗方式不同,将100例AMI患者分为对照组(n=49)和观察组(n=51);对照组采用体外反博治疗(ECP),观察组采用EECP治疗。比较两组治疗前后出血评分(CRUSADE)、心功能评分(Killip分级)、内分泌因子[血清甲状旁腺素(PTH)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、血浆肾素水平(PRA)]和血流动力学[左心室射血分数(LVEF)、每博出量(SV)、心输出量(CO)]变化。结果:治疗后,两组患者血细胞比容、收缩压、肌酐清除率、心率等CRUSADE评分项目均改善,且观察组患者的出血改善状态好于对照组(P<0.05);观察组患者心功能分级Ⅰ级占比高于对照组(P<0.05);观察组患者血清PTH、ALD、PRA水平高于对照组,而AngⅡ水平低于对照组(P<0.05);观察组LVEF、SV、CO高于对照组(P<0.05)。结论:对AMI患者实施EECP治疗可调节RAAS,改善心功能,提高临床疗效。Objective:To explore the influence of enhanced external counterpulsation(EECP) on cardiac function and renin-angiotensin-aldosterone system(RAAS) in patients with acute myocardial infarction(AMI).Methods:The clinical data of 100 patients with AMI were retrospectively collected.According to different treatment methods,the research subjects were divided into control group [49 cases,external counterpulsation(ECP)] and observation group(51 cases,EECP treatment).The efficacy of the two groups was compared,and the bleeding score(CRUSADE),cardiac function score(Killip),endocrine factors [serum parathyroid hormone(PTH),angiotensin II(Ang II),aldosterone(ALD),plasma rennin(PRA)] and hemodynamics [left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO)] before and after treatment were compared in the two groups.Results:As for CRUSADE score,the hematocrit,systolic blood pressure,creatinine clearance rate and heart rate of the two groups were improved after treatment,and the bleeding improvement of observation group was better than that of control group(P<0.05).According to Killip grading,the proportion of cardiac function grade I of observation group after treatment was higher than that of control group(P<0.05).Comparison of endocrine factors showed that the levels of PTH,ALD and PRA after treatment in observation group were higher than those in control group while the level of Ang II was lower than that in control group(P<0.05).The hemodynamic indicators of LVEF,SV and CO after treatment in observation group were higher than those in control group(P<0.05).Conclusion:EECP for patients with AMI can adjust the renin-angiotensin-aldosterone system,improve the cardiac function,and enhance the efficacy.

关 键 词：急性心肌梗塞 增强型体外反博治疗 心功能 心脏康复 肾素-血管紧张素-醛固酮系统 

分 类 号：R542.2[医药卫生—心血管疾病]