中国心血管病研究2024，Vol.22Issue(1) ：66-71.DOI:10.3969/j.issn.1672-5301.2024.01.012

体外反搏治疗对合并稳定性冠心病的射血分数中间值心力衰竭患者心功能和生活质量影响的临床研究

Clinical study on the effect of external counterpulsation on cardiac function and quality of life in patients with median-range ejection fraction complicated with stable coronary heart disease

陈斐 陈玮 郭薇薇 方芳 高小泽 周军
中国心血管病研究2024，Vol.22Issue(1) ：66-71.DOI:10.3969/j.issn.1672-5301.2024.01.012
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体外反搏治疗对合并稳定性冠心病的射血分数中间值心力衰竭患者心功能和生活质量影响的临床研究

Clinical study on the effect of external counterpulsation on cardiac function and quality of life in patients with median-range ejection fraction complicated with stable coronary heart disease

陈斐 1陈玮 2郭薇薇 2方芳 2高小泽 2周军2
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作者信息

  • 1. 200070 上海市,上海市静安区闸北中心医院全科医学科
  • 2. 200070 上海市,上海市静安区闸北中心医院心血管内科
  • 折叠

摘要

目的 探讨体外反搏治疗对合并稳定性冠心病的射血分数中间值心力衰竭(HFmrEF)患者心功能和生活质量影响.方法 选取2021年12月至2022年6月入上海市静安区闸北中心医院心血管内科住院治疗的合并稳定性冠心病的HFmrEF患者80例作为研究对象,随机数字法分为对照组和体外反搏组,对照组给与常规药物治疗,体外反搏组在常规药物治疗基础上联合体外反搏治疗,记录并比较两组患者治疗12个月后的心功能指标、血清N末端B型利钠肽原(NT-proBNP)水平、6 min步行距离、生活质量、临床疗效、安全性指标以及心血管不良事件发生情况.结果 治疗12个月后,两组患者左心室短轴缩短率(LVFS)和左心室射血分数(LVEF)明显高于治疗前(P<0.001),左心室舒张末期内径(LVEDD)明显低于治疗前(P<0.001),而且体外反搏组的LVFS和LVEF明显高于对照组[(28.51±2.83)%比(23.69±2.16)%、(46.83±3.67)%比(45.27±3.41)%,P<0.05],LVEDD明显低于对照组[(46.69±6.32)%比(51.81±6.06)%,P<0.001];两组患者血清中NT-proBNP水平明显低于治疗前,6 min步行距离明显高于治疗前,而且体外反搏组的NT-proBNP水平明显低于对照组[518.45(446.47,784.13)ng/L比697.18(542.03,1093.29)ng/L,P<0.05],6 min步行距离明显高于对照组[(441.63±69.15)m比(387.26±65.43)m,P<0.001];两组MLHFQ评分明显低于治疗前,而且体外反搏组的MLHFQ评分明显低于对照组(P<0.001);体外反搏组的总有效率为97.50%,明显高于对照组的总有效率85.90%(P<0.05);两组治疗前后生命体征平稳,具有良好的安全性,体外反搏组治疗后心血管不良事件发生率明显低于对照组(P<0.05).结论 体外反搏治疗可提升稳定性冠心病合并HFmrEF患者的心功能,改善生活质量,降低心血管不良事件发生率,疗效显著.

Abstract

Objective To investigate the effect of extracorporeal counterpulsation on cardiac function and quality of life in patients with median-range ejection fraction complicated with stable coronary heart disease.Methods A totle of 80 heart failure with mid-range ejection fraction(HFmrEF)patients with stable coronary heart disease admitted to Department of Cardiovascular Medicine,Zhabei Central Hospital,Shanghai from december 2021 to June 2022 were selected as the study objects,and were divided into the control group and external counterpulsation(ECP)group by random number method.The control group was given conventional drug treatment,and the ECP group was combined with external counterpulsation therapy on the basis of conventional drug treatment.Cardiac function indexes,serum NT-proBNP level,6-minute walking distance,quality of life,clinical efficacy,safety indexes and cardiovascular adverse events were recorded and compared between the two groups after 12 months of treatment.Results After 12 months of treatment,left ventricular brachyaxis shortening rate(LVFS)and left ventricular ejection fraction(LVEF)were significantly higher than before treatment(P<0.001)and left ventricular end-diastolic diameter(LVEDD)was significantly lower than before treatment(P<0.001)in both 2 groups.LVFS and LVEF in the ECP group were significantly higher than those in the control group[(28.51±2.83)%vs.(23.69±2.16)%、(46.83±3.67)%vs.(45.27±3.41)%,P<0.05],and LVEDD was significantly lower than that in the control group[(46.69±6.32)%vs.(51.81±6.06)%,P<0.001].The serum level of NT-proBNP in both two groups was significantly lower than before treatment;the walking distance of 6 min in both two groups was significantly longer than before treatment;the level of NT-proBNP in the ECP group was significantly lower than that in the control group[518.45(446.47,784.13)ng/L vs.697.18(542.03,1093.29)ng/L,P<0.05]and the walking distance of 6 min in the ECP group was significantly longer than that in the control group[(441.63±69.15)m vs.(387.26±65.43)m](P<0.001).The MLHFQ score of the two groups was significantly lower than before treatment,and the MLHFQ score of the ECP group was significantly lower than that of the control group(P<0.001).The total effective rate of the ECP group was 97.50%,which was significantly higher than that of the control group 85.90%(P<0.05).The vital signs of the two groups were stable before and after treatment,and the incidence of cardiovascular adverse events in the ECP group was significantly lower than that in the control group(P<0.05).Conclusions ECP can improve the cardiac function,improve the quality of life and reduce the incidence of adverse cardiovascular events in patients with stable coronary heart disease combined with HFmrEF.

关键词

稳定性冠心病/射血分数中间值心力衰竭/体外反搏/心功能/生活质量/N末端B型利钠肽原

Key words

Stable coronary heart disease/Heart failure with mid-range ejection fraction/External counterpulsation/Heart function/Quality of life/N-terminal-pro-B-type natriuretic peptide

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基金项目

上海市卫生健康委科研项目面上项目(202040038)

上海市静安区学科建设项目(培育学科)(2021PY02)

上海市静安区卫生健康委项目(2020MS05)

出版年

2024
中国心血管病研究
中国医师协会，煤炭总医院

中国心血管病研究

CSTPCD
影响因子：0.878
ISSN：1672-5301
参考文献量24
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