体外反搏联合尼可地尔治疗冠状动脉微循环功能障碍的临床效果及对运动耐力的影响  

Clinical effect of external counterpulsation combined with nicorandil in the treatment of coronary microvascular dysfunction and its influence on exercise endurance

作　　者：张瑞凡[1] 丁钰轩[2] 王露利 王瑞珏 ZHANG Ruifan;DING Yuxuan;WANG Louli;WANG Ruijue(ECG Center,Hanzhong People's Hospital,Hanzhong 723000;Cardiovascular Internal Medicine Department,Hanzhong People's Hospital,Hanzhong 723000;Cardiovascular Internal Medicine Department,Hanzhong Central Hospital,Hanzhong 723000;Cardiovascular Internal Medicine Department,ChengguCounty Hospital,Hanzhong 723200,China)

机构地区：[1]汉中市人民医院心电中心,陕西汉中723000 [2]汉中市人民医院心血管内科,陕西汉中723000 [3]汉中市中心医院心血管内科,陕西汉中723000 [4]城固县医院心血管内科,陕西汉中723200

出　　处：《临床医学研究与实践》2023年第33期39-42,共4页Clinical Research and Practice

基　　金：陕西省卫生健康科研基金项目(No.2018D013)。

摘　　要：目的分析体外反搏(ECP)联合尼可地尔治疗冠状动脉微循环功能障碍(CMVD)的临床效果。方法选取2019年7月至2021年7月收治的80例CMVD患者为研究对象,根据入院先后顺序将其分为对照组(n=40,常规治疗)和研究组(n=40,在对照组基础上联合ECP+尼可地尔)治疗。比较两组的治疗效果。结果治疗后,研究组的左心室射血分数、血流与环运动速度比、每搏输出量优于对照组(P<0.05)。治疗后,研究组的血小板黏附率、冠脉微循环阻力指数(IMR)、基础肱动脉内径、基础血流量优于对照组(P<0.05)。治疗后,研究组的内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)、血管紧张素Ⅱ(AngⅡ)水平低于对照组,一氧化氮(NO)水平高于对照组(P<0.05)。治疗2、4、6个月后,研究组的6 min步行距离测试(6MWT)长于对照组(P<0.05)。结论ECP联合尼可地尔治疗CMVD的临床效果理想,有利于改善心功能、血液流动力学以及血清学指标,提高运动耐力,值得临床应用。Objective To analyze the clinical effect of extemal counterpulsation(ECP)combined with nicorandil in the treatment of coronary microvascular dysfunction(CMVD).Methods A total of 80 patients with CMVD admitted from July 2019 to July 2021 were selected as the research objects.According to the order of admission,the patients were divided into control group(n=40,routine treatment)and study group(n=40,combined with ECP+nicorandil treatment on the basis of the control group).The therapeutic effects of the two groups were compared.Results After treatment,the left ventricular ejection fraction,the ratio of blood flow to ring velocity and the output per stroke in the study group were better than those in the control group(P<0.05).After treatment,the platelet adhesion rate,index of microcirculatory resistance(IMR),basic brachial artery diameter and basic blood flow in the study group were better than those in the control group(P<0.05).After treatment,the levels of endothelin-1(ET-1),tumor necrosis factor-α(TNF-α)and angiotensinⅡ(AngⅡ)in the study group were lower than those in the control group,and the level of nitric oxide(NO)was higher than that in the control group(P<0.05).After 2,4 and 6 months of treatment,the 6-minute walk test(6MWT)of the study group was longer than that of the control group(P<0.05).Conclusion The ECP combined with nicorandil in the treatment of CMVD has ideal clinical effect,it is conducive to improving cardiac function,hemodynamics and serological indicators,and improving exercise endurance,which is worthy of clinical application.

关 键 词：冠状动脉微循环功能障碍 体外反搏 尼可地尔 运动耐力 

分 类 号：R541.4[医药卫生—心血管疾病]