本文選題：冠心病　切入點(diǎn)：增強(qiáng)型體外反搏　出處：《鄭州大學(xué)》2017年碩士論文

【摘要】：目的觀察冠心病患者經(jīng)增強(qiáng)型體外反搏(Enhanced external counterpulsation,EECP)15個(gè)小時(shí)治療前后心臟結(jié)構(gòu)和功能的變化,探討EECP對(duì)冠心病患者早期心臟重塑的影響。方法將200例冠心病患者隨機(jī)分為對(duì)照組100例,EECP組100例,對(duì)照組服用抗血小板聚集藥、調(diào)脂藥、β受體阻滯劑等藥物,EECP組在服用上述藥物的同時(shí),每天行兩次EECP治療,每次半個(gè)小時(shí),總治療時(shí)間15個(gè)小時(shí),對(duì)比治療前后兩組超聲心動(dòng)圖的E峰、A峰、心房收縮期末左心房?jī)?nèi)徑(LA)、心室舒張期末左心室內(nèi)徑(LVEDD)、左心室射血分?jǐn)?shù)(LVEF)的變化,采用熒光免疫法和化學(xué)發(fā)光免疫分析法分別檢測(cè)血清N-末端B型利鈉肽原(NT-proBNP)和內(nèi)皮素-1(ET-1)的變化。結(jié)果與治療前比較:EECP組治療后,NT-proBNP(90.77±7.23)pg/ml vs(119.36±8.63)pg/ml、ET-1(70.37±33.28)pg/ml vs(134.76±28.69)pg/ml、LA(33.31±6.10)mm vs(37.81±6.05)mm值均較治療前降低,E峰(0.77±0.12)m/s vs(0.59±0.10)m/s、LVEF(66.83±10.05)%vs(56.41±11.19)%、LVEDD(51.13±3.15)mm vs(48.94±4.26)mm值均較治療前升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);EECP組A峰治療前后的變化無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)照組治療后,NT-proBNP(103.61±10.33)pg/ml vs(116.21±8.19)pg/ml、ET-1(98.73±34.67)pg/ml vs(116.35±39.68)pg/ml值均較治療前降低,E峰(0.72±0.09)m/s vs(0.66±0.12)m/s、LVEF(59.90±9.08)%vs(55.60±10.50)%值均較治療前升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)照組A峰、LVEDD、LA值治療前后的變化無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療前后變化值的比較:EECP組NT-proBNP的降低值(-29.83±6.19)pg/ml比對(duì)照組NT-proBNP的降低值(-12.24±3.06)pg/ml,EECP組ET-1的降低值(-65.59±16.17)pg/ml比對(duì)照組ET-1的降低值(-5.97±1.03)pg/ml均顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P均0.05);EECP組E峰的升高值(0.18±0.03)m/s比對(duì)照組E峰的升高值(0.06±0.01)m/s,EECP組LVEF的升高值(11.00±0.36)%比對(duì)照組LVEF的升高值(5.01±0.19)%均顯著升高,差異有統(tǒng)計(jì)學(xué)意義(P均0.01)。結(jié)論EECP可改善冠心病患者心房和心室結(jié)構(gòu),提高心臟的收縮和舒張功能,提示其可改善對(duì)冠心病患者早期的心臟重塑。
[Abstract]:Objective to observe the changes of cardiac structure and function in patients with coronary heart disease before and after 15 hours of treatment with enhanced external counterpulsation. Methods 200 patients with coronary heart disease were randomly divided into control group (n = 100) and control group (n = 100). EECP group was treated with EECP twice a day for half an hour each time for a total of 15 hours. The E peak A peak of echocardiography was compared before and after treatment. The changes of left atrial diameter, left ventricular diameter, left ventricular ejection fraction and left ventricular ejection fraction (LVEF) at the end of atrial contraction, left ventricular end diastolic, left ventricular end diastolic, and left ventricular ejection fraction (LVEF). Fluorescence immunoassay and chemiluminescent immunoassay were used to detect the changes of serum NT-proBNPs and endothelin 1 ET-1.Results compared with those before and after treatment, NT-proBNP90.77 鹵7.23)pg/ml vs(119.36 鹵8.63pgmlET-170.37 鹵33.28)pg/ml vs(134.76 鹵28.69pgml vs(37.81 鹵6.05)mm decreased E peak 0.77 鹵0.12)m/s 鹵6.05)mm. Vs(0.59 鹵0.10 m / s of LVEF was 66.83 鹵10.05)%vs(56.41 鹵11.19 and 51.13 鹵3.15)mm vs(48.94 鹵4.26)mm were higher than those before treatment. There was no significant difference between the two groups before and after treatment, while in the control group, the value of NT-proBNPP 103.61 鹵10.33)pg/ml 鹵8.19 vs(116.21 鹵8.19 vs(116.21 鹵34.67)pg/ml vs(116.35 鹵39.68)pg/ml decreased E peak 0.72 鹵0.09)m/s vs(0.66 鹵0.12msLVEFV 59.90 鹵9.08)%vs(55.60 鹵10.50%. The difference was statistically significant (P 0.05), but there was no significant difference between the two groups before and after treatment. The decrease value of NT-proBNP in the control group was -29.83 鹵6.19)pg/ml, which was lower than that in the control group (-12.24 鹵3.06 鹵3.06 鹵3.06 鹵3.06g 路ml / ml ET-1 / 16.17)pg/ml = -65.59 鹵16.17)pg/ml) before and after treatment. The decrease value of ET-1 in radiation group was significantly lower than that in control group (-5.97 鹵1.03)pg/ml). The difference was statistically significant (P < 0.05). The elevated value of E peak (0.18 鹵0.03)m/s) in the EECP group was significantly higher than that in the control group (0.06 鹵0.01m / s). The elevated value of LVEF in the EECP group was 11.00 鹵0.36% higher than that in the control group (5.01 鹵0.19%), and it was significantly higher than that in the control group (5.01 鹵0.19%). Conclusion EECP can improve atrial and ventricular structure and systolic and diastolic function in patients with coronary heart disease, suggesting that EECP can improve early cardiac remodeling in patients with coronary heart disease.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.4

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