实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
2015年
9期
93-95,96
,共4页
心绞痛%增强型体外反搏%炎性因子%治疗结果
心絞痛%增彊型體外反搏%炎性因子%治療結果
심교통%증강형체외반박%염성인자%치료결과
Angina pectoris%Enhanced external counter pulsation%Inflammatory cytokines%Treatment outcome
目的：探讨增强型体外反搏（ EECP）治疗心绞痛的临床疗效及其对炎性因子的影响。方法选取2014年1月—2015年4月在宝鸡市人民医院治疗的心绞痛患者92例，按照随机数字表法分为对照组和观察组，各46例。对照组患者给予常规药物治疗，观察组患者在对照组治疗基础上给予 EECP 治疗，2周为1个疗程，均持续治疗2个疗程。治疗3个月后判定两组患者临床疗效，比较两组患者治疗前及治疗3个月后西雅图心绞痛量表（SAQ）评分和6分钟步行距离（6MWD），治疗前和治疗4周后血清白介素6（ IL -6）、白介素10（ IL -10）、肿瘤坏死因子α（TNF -α）、超敏 C 反应蛋白（hs - CRP）、基质金属蛋白酶9（MMP -9）、内皮素1（ET -1）及血管紧张素Ⅱ（AngⅡ）水平；变量间的相关性分析采用 Pearson 相关性分析。结果观察组患者显效30例、有效11例、无效5例，对照组患者显效23例、有效10例、无效13例，观察组患者临床疗效优于对照组（u =0.094，P =1.677）。治疗前两组患者 SAQ 评分和6MWD 比较，差异无统计学意义（P >0.05）；治疗3个月后观察组患者 SAQ 评分高于对照组，6MWD长于对照组（P <0.05）。治疗前两组患者血清 IL -6、IL -10、TNF -α、hs - CRP、MMP -9、ET -1及 AngⅡ水平比较，差异无统计学意义（P >0.05）；治疗4周后观察组患者血清 IL -6、TNF -α、hs - CRP、MMP -9、ET -1及 AngⅡ水平低于对照组，而 IL -10水平高于对照组（P <0.05）。Pearson 相关性分析显示，血清 IL -6、hs - CRP 水平与血清 AngⅡ水平呈正相关（r 值分别为0.224、0.104，P <0.05），血清 MMP -9水平与血清 ET -1水平呈正相关（r =0.173，P <0.05）。结论 EECP 治疗心绞痛的临床疗效确切，能减轻患者心绞痛严重程度，其作用机制可能与减少炎性因子释放、保护血管内皮细胞功能有关。
目的：探討增彊型體外反搏（ EECP）治療心絞痛的臨床療效及其對炎性因子的影響。方法選取2014年1月—2015年4月在寶鷄市人民醫院治療的心絞痛患者92例，按照隨機數字錶法分為對照組和觀察組，各46例。對照組患者給予常規藥物治療，觀察組患者在對照組治療基礎上給予 EECP 治療，2週為1箇療程，均持續治療2箇療程。治療3箇月後判定兩組患者臨床療效，比較兩組患者治療前及治療3箇月後西雅圖心絞痛量錶（SAQ）評分和6分鐘步行距離（6MWD），治療前和治療4週後血清白介素6（ IL -6）、白介素10（ IL -10）、腫瘤壞死因子α（TNF -α）、超敏 C 反應蛋白（hs - CRP）、基質金屬蛋白酶9（MMP -9）、內皮素1（ET -1）及血管緊張素Ⅱ（AngⅡ）水平；變量間的相關性分析採用 Pearson 相關性分析。結果觀察組患者顯效30例、有效11例、無效5例，對照組患者顯效23例、有效10例、無效13例，觀察組患者臨床療效優于對照組（u =0.094，P =1.677）。治療前兩組患者 SAQ 評分和6MWD 比較，差異無統計學意義（P >0.05）；治療3箇月後觀察組患者 SAQ 評分高于對照組，6MWD長于對照組（P <0.05）。治療前兩組患者血清 IL -6、IL -10、TNF -α、hs - CRP、MMP -9、ET -1及 AngⅡ水平比較，差異無統計學意義（P >0.05）；治療4週後觀察組患者血清 IL -6、TNF -α、hs - CRP、MMP -9、ET -1及 AngⅡ水平低于對照組，而 IL -10水平高于對照組（P <0.05）。Pearson 相關性分析顯示，血清 IL -6、hs - CRP 水平與血清 AngⅡ水平呈正相關（r 值分彆為0.224、0.104，P <0.05），血清 MMP -9水平與血清 ET -1水平呈正相關（r =0.173，P <0.05）。結論 EECP 治療心絞痛的臨床療效確切，能減輕患者心絞痛嚴重程度，其作用機製可能與減少炎性因子釋放、保護血管內皮細胞功能有關。
목적：탐토증강형체외반박（ EECP）치료심교통적림상료효급기대염성인자적영향。방법선취2014년1월—2015년4월재보계시인민의원치료적심교통환자92례，안조수궤수자표법분위대조조화관찰조，각46례。대조조환자급여상규약물치료，관찰조환자재대조조치료기출상급여 EECP 치료，2주위1개료정，균지속치료2개료정。치료3개월후판정량조환자림상료효，비교량조환자치료전급치료3개월후서아도심교통량표（SAQ）평분화6분종보행거리（6MWD），치료전화치료4주후혈청백개소6（ IL -6）、백개소10（ IL -10）、종류배사인자α（TNF -α）、초민 C 반응단백（hs - CRP）、기질금속단백매9（MMP -9）、내피소1（ET -1）급혈관긴장소Ⅱ（AngⅡ）수평；변량간적상관성분석채용 Pearson 상관성분석。결과관찰조환자현효30례、유효11례、무효5례，대조조환자현효23례、유효10례、무효13례，관찰조환자림상료효우우대조조（u =0.094，P =1.677）。치료전량조환자 SAQ 평분화6MWD 비교，차이무통계학의의（P >0.05）；치료3개월후관찰조환자 SAQ 평분고우대조조，6MWD장우대조조（P <0.05）。치료전량조환자혈청 IL -6、IL -10、TNF -α、hs - CRP、MMP -9、ET -1급 AngⅡ수평비교，차이무통계학의의（P >0.05）；치료4주후관찰조환자혈청 IL -6、TNF -α、hs - CRP、MMP -9、ET -1급 AngⅡ수평저우대조조，이 IL -10수평고우대조조（P <0.05）。Pearson 상관성분석현시，혈청 IL -6、hs - CRP 수평여혈청 AngⅡ수평정정상관（r 치분별위0.224、0.104，P <0.05），혈청 MMP -9수평여혈청 ET -1수평정정상관（r =0.173，P <0.05）。결론 EECP 치료심교통적림상료효학절，능감경환자심교통엄중정도，기작용궤제가능여감소염성인자석방、보호혈관내피세포공능유관。
Objective To investigate the clinical effect of enhanced external counter pulsation( EECP)on angina pectoris and its impact on inflammatory cytokines. Methods A total of 92 patients with angina pectoris were selected in the People's Hospital of Baoji from January 2014 to April 2015,and they were divided into control group and observation group according to random number table,each of 46 cases. Patients of control group received conventional drug treatment,while patients of observation group received extra EECP based on conventional drug treatment,both groups treated for 2 courses(two weeks as a course). After 3 months of treatment,clinical effect was judged,SAQ score and 6 - minute walk distance before treatment and after 3 months of treatment were compared between the two groups,and serum levels of IL - 6,IL - 10,TNF - α, hs - CRP,MMP - 9,ET - 1 and AngⅡ before treatment and after 4 weeks of treatment were compared between the two groups;correlations between variables were analyzed by Pearson correlation analysis. Results Of observation group,30 cases got excellent effect,11 cases got good effect,5 cases were invalid;of control group,23 cases got excellent effect,10 cases got good effect,13 cases were invalid,the clinical effect of observation group was statistically significantly better than that of control group(u = 0. 094,P = 1. 677). No statistically significant differences of SAQ score or 6 - minute walk distance was found between the two groups before treatment( P > 0. 05);after 3 months of treatment,SAQ score of observation group was statistically significantly higher than that of control group,and 6 - minute walk distance of observation group was statistically significantly longer than that of control group(P < 0. 05). No statistically significant differences of serum levels of IL - 6,IL -10,TNF - α,hs - CRP,MMP - 9,ET - 1 or AngⅡ was found between the two groups before treatment(P > 0. 05);after 4 weeks of treatment,serum levels of IL - 6,TNF - α,hs - CRP,MMP - 9,ET - 1 and AngⅡ of observation group were statistically significantly lower than those of control group,while serum IL - 10 level of observation group was statistically significantly higher than that of control group(P < 0. 05). Pearson correlation analysis showed that,serum IL - 6 level(r =0. 224,P < 0. 05 ),serum hs - CRP level( r = 0. 104,P < 0. 05 ) was positively correlated with serum Ang Ⅱ level, respectively,and serum MMP - 9 level was positively correlated with serum ET - 1 level(r = 0. 173,P < 0. 05). Conclusion EECP has certain clinical effect on angina pectoris,can effectively relieve the illness severity,its mechanism may related with reducing the release of inflammatory cytokines,protection of vascular endothelial cell function.
