低强度脉冲式超声波治疗老年冠心病心绞痛患者的疗效观察  

Efficacy of low-intensity pulsed ultrasound therapy in elderly patients with coronary heart disease and angina pectoris

作　　者：陈畅 张金鹏 彭洁[1] 曹爱红[1] 陈晓明[1] 张晨 沈琳[1] Chen Chang;Zhang Jinpeng;Peng Jie;Cao Aihong;Chen Xiaoming;Zhang Chen;Shen Lin(Department of Geriatric Medicine,Qilu Hospital of Shandong University,Shandong Provincial Key Laboratory of Cardiovascular Proteomics,Jinan 250012,China;Weifang Medical University,Weifang 250355,China)

机构地区：[1]山东大学齐鲁医院老年医学科,山东省心血管疾病蛋白质组学重点实验室,济南250012 [2]潍坊医学院,潍坊250355

出　　处：《中华老年医学杂志》2023年第1期18-22,共5页Chinese Journal of Geriatrics

摘　　要：目的探讨低强度脉冲式超声波(LIPUS)治疗在老年冠心病心绞痛患者中的应用效果及对血流动力学的影响。方法单中心随机对照研究,连续入选2021年11月至2022年8月在山东大学齐鲁医院治疗的老年冠心病心绞痛患者66例。随机数字表法分为超声组和对照组各33例,2组患者均给予常规药物治疗,超声组在此基础上辅以LIPUS治疗。治疗20次后比较临床疗效、治疗前后血脂水平、炎症因子及无创血流动力学指标。结果超声组和对照组患者基线临床资料比较,差异无统计学意义(均P>0.05)。疗程结束后,超声组显效12例(36.4%),有效18例(54.5%),无效2例(6.1%),加重1例(3%),总有效率为90.9%;对照组显效2例(6.1%),有效19例(57.6%),无效9例(27.3%),总有效率为63.6%。超声组疗效优于对照组,差异有统计学意义(P<0.05)。治疗后超声组与对照组患者比较总胆固醇降低,(2.31±1.03)mmol/L比(4.36±0.76)mmol/L(P<0.01);低密度脂蛋白胆固醇降低,(1.24±0.70)mmol/L比(1.74±0.44)mmol/L(P<0.01);三酰甘油降低,(1.04±0.40)mmol/L比(1.28±0.49)mmol/L(P<0.05);载脂蛋白B降低,(0.67±0.25)g/L比(0.90±0.14)g/L(P<0.01)。白细胞介素6降低,(2.87±2.52)ng/L比(4.66±3.30)ng/L(P<0.05);超敏C反应蛋白降低,(1.04+1.41)mg/L比(3.80+5.78)mg/L(P<0.05)。血流动力学指标心排血量增加,(4.92±1.05)L/min比(4.39±0.97)L/min(P<0.05);每搏量增加,(75.85±17.50)ml/beat比(66.97±15.57)ml/beat(P<0.05);心脏指数增加,(3.05±0.45)L/min2比(2.51±0.43)L/min2(P<0.01);心搏指数增加,(37.50±7.14)ml·beat-1·m-2比(43.29±7.96)ml·beat-1·m-2(P<0.01);系统阻力减低,(1358.29±325.23)dyne·s-1·cm-5比(1617.94±526.27)dyne·s-1·cm-5(P<0.05);血管总阻力降低,(4.07±24.30)%比(21.32±31.94)%(P<0.05);心率降低,(63.43±7.42)次/min比(69.11±10.89)次/min(P<0.05)。结论LIPUS治疗可改善老年冠心病心绞痛患者症状、血脂、炎症因子和血流动力学指标,是老年冠心病心绞痛患者安全、有效的�Objective To investigate the practical efficacy of low-intensity pulsed ultrasound(LIPUS)and its effects on hemodynamics in patients with coronary heart disease and angina pectoris.Methods As a single-center randomized controlled study,66 elderly patients with coronary heart disease and angina pectoris treated at Qilu Hospital of Shandong University between November 2021 and August 2022 were consecutively recruited.Participants were divided into an ultrasound group and a control group via the random number table method,with 33 in each group.Both groups were given conventional drug treatment,and the ultrasound group was supplemented with LIPUS treatment.After 20 sessions of treatment,the clinical efficacy,blood lipid levels,inflammatory factors and hemodynamics from noninvasive monitoring before and after treatment were compared.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).After treatment,marked effectiveness was seen in 12 cases(36.4%),effectiveness in 18 cases(54.5%),ineffectiveness in 2 cases(6.1%)and aggravation in 1 case(3%)in the ultrasound group,with a total effectiveness rate of 90.9%.In the control group,marked effectiveness was seen 2 cases(6.1%),effectiveness in 19 cases(57.6%)and ineffectiveness in 9 cases(27.3%),with a total effectiveness rate of 63.6%.Statistically significant favorable results were achieved in the ultrasound treatment group,compared with the control group(P<0.05).Also,compared with the control group,patients in the ultrasound group showed lower total cholesterol[(2.31±1.03)mmol/L vs.(4.36±0.76)mmol/L,P<0.01],decreased low-density lipoprotein cholesterol[(1.24±0.70)mmol/L vs.(1.74±0.44)mmol/L,P<0.01],decreased triglycerides[(1.04±0.40)mmol/L vs.(1.28±0.49)mmol/L,P<0.05],decreased apolipoprotein B[(0.67±0.25)g/L vs.(0.90±0.14)g/L,P<0.01],decreased interleukin-6[(2.87±2.52)ng/L vs.(4.66±3.30)ng/L,P<0.05],and decreased high-sensitivity C-reactive protein[(1.04±1.41)mg/L vs.(3.80±5.78)mg/L,P<0.05].Concerning hemod

关 键 词：心绞痛 血流动力学 低强度脉冲式超声波 

分 类 号：R541.4[医药卫生—心血管疾病]