本文選題：增強(qiáng)型體外反搏 + 遠(yuǎn)端缺血預(yù)處理�。� 參考：《河北醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:探討增強(qiáng)型體外反搏(EECP)、遠(yuǎn)端缺血預(yù)處理(RIPC)及兩者聯(lián)合對冠心病患者內(nèi)皮功能的影響。方法:選擇2015年3月至2015年12月在我院康復(fù)科門診就醫(yī)的冠心病患者80例,將其隨機(jī)分為對照組20例,EECP組20例,RIPC組20例及聯(lián)合組20例,所有患者均接受常規(guī)藥物治療(抗血小板、硝酸酯類、鈣拮抗劑、β受體阻滯劑等)。其中,EECP組患者每日給予增強(qiáng)型體外反搏治療(50min,2次/日,連續(xù)18天),RIPC組患者每日行左上肢缺血預(yù)處理治療(充氣5min*放氣5min,5個(gè)循環(huán),1次/日,連續(xù)18天),聯(lián)合組每日給予增強(qiáng)型體外反搏+左上肢缺血預(yù)處理治療(50min,2次EECP+1次RIPC/日,連續(xù)18天),所有受試者分別與治療前、后測定血漿NO2-/NO3-、ET-1及血清IL-6、TNF-a水平。結(jié)果:(1)EECP組、RIPC組及聯(lián)合組患者治療后血漿NO2-/NO3-水平均高于對照組水平[(99.42±9.32)、(89.78±6.39)、(97.62±10.33)vs(80.65±8.66)umol/L,P0.05],其中EECP組與聯(lián)合組血漿NO2-/NO3-水平均高于RIPC組[(99.42±9.32)、(97.62±10.33)vs(89.78±6.39)umol/L,P0.05]但這兩者之間差異無統(tǒng)計(jì)學(xué)意義[(99.42±9.32)vs(97.62±10.33)umol/L,P0.05](2)EECP組、RIPC組及聯(lián)合組患者治療后血漿ET-1及均低于對照組水平[(109.58±14.41)、(147.47±34.27)、(112.15±15.43)vs(175.63±34.93)ng/L,P0.05],其中EECP組與聯(lián)合組血漿ET-1水平均低于RIPC組[(109.58±14.41)、(112.15±15.43)vs(147.47±34.27)ng/L,P0.05],但這兩組之間差異無統(tǒng)計(jì)學(xué)意義[(109.58±14.41)vs(112.15±15.43)ng/L,P0.05];(3)EECP組、RIPC組及聯(lián)合組患者治療后血清IL-6水平均低于對照組水平[(12.05±1.78)、(15.11±2.64)、(13.04±1.34)vs(18.65±2.65)ng/L,P0.05],其中EECP組與聯(lián)合組血漿IL-6水平均低于RIPC組[(12.05±1.78)、(13.04±1.34)vs(15.11±2.64)ng/L,P0.05],但這兩組之間差異無統(tǒng)計(jì)學(xué)意義[(12.05±1.78)vs(13.04±1.34)ng/L,P0.05];(4)EECP組、RIPC組及聯(lián)合組患者治療后血清TNF-a水平均低于對照組水平[(316.97±24.25)、(361.85±52.38)、(322.83±44.43)s(406.90±44.12)ng/L,P0.05],其中EECP組與聯(lián)合組血清TNF-a水平均低于RIPC組[(316.97±24.25)、(322.83±44.43)vs(361.85±52.38)ng/L,P0.05],但這兩組之間差異無統(tǒng)計(jì)學(xué)意義[(316.97±24.25)vs(322.83±44.43)ng/L,P0.05]。結(jié)論:增強(qiáng)型體外反搏及遠(yuǎn)端缺血預(yù)處理均可減輕機(jī)體炎癥水平,改善冠心病患者內(nèi)皮功能,但兩者聯(lián)合效果并不比單純增強(qiáng)型體外反搏強(qiáng)。
[Abstract]:Objective: To investigate the effect of enhanced extracorporeal counterpulsation (EECP), distal ischemic preconditioning (RIPC) and both on the endothelial function of patients with coronary heart disease. Methods: 80 cases of coronary heart disease were selected from March 2015 to December 2015 in our hospital, and were randomly divided into 20 cases, 20 cases in group EECP, 20 cases in group RIPC and 20 cases in combination group. The patients received conventional medication (antiplatelet, nitrates, calcium antagonist, beta blocker, etc.). In group EECP, patients were given enhanced external counterpulsation (50min, 2 / day, 18 days), and group RIPC patients were treated daily with left upper limb ischemic preconditioning treatment (inflatable 5min* release 5min, 5 circulation, 1 / day, 18 consecutive days), combined for 18 days. The group was treated with enhanced external counterpulsation and left upper limb ischemic preconditioning (50min, 2 times EECP+1 RIPC/ day, 18 days for consecutive days). All the subjects measured plasma NO2-/NO3-, ET-1 and serum IL-6, TNF-a levels before and after treatment. Results: (1) the level of NO2-/NO3- in the group of EECP, RIPC group and combined group was higher than that of the control group [99 .42 + 9.32), (89.78 + 6.39), (97.62 + 10.33) vs (80.65 + 8.66) umol/L, P0.05], and the level of plasma NO2-/NO3- in group EECP and combined group was higher than that in group RIPC [(99.42 + 9.32), (97.62 + 10.33) vs (89.78 + 6.39) umol/L, P0.05] but there was no statistical significance [(99.42 +] vs) umol/L After treatment, the plasma ET-1 was lower than that of the control group [(109.58 + 14.41), (147.47 + 34.27), (112.15 + 15.43) vs (175.63 + 34.93) ng/L, P0.05], and the level of plasma ET-1 in EECP group and combined group was lower than that in group RIPC [109.58 + 14.41), (112.15 + 15.43) vs (147.47 +%) ng/L, P0.05], but there was no significant difference between these groups 8 + 14.41) vs (112.15 + 15.43) ng/L, P0.05]; (3) EECP group, RIPC group and combined group after treatment, the mean serum IL-6 water was lower than that of the control group [12.05 + 1.78), (15.11 + 2.64), (13.04 + 2.64) vs (18.65 + 2.65) ng/L, P0.05], among which the EECP group and the combined group plasma IL-6 water were lower than that of the RIPC group. .05], but there was no significant difference between the two groups [(12.05 + 1.78) vs (13.04 + 1.34) ng/L, P0.05]; (4) the serum TNF-a level in EECP group, RIPC group and combined group was lower than that of the control group [316.97 + 24.25), (361.85 + 52.38), (322.83 + 44.43) s (406.90 + 44.12) ng/L, P0.05], and EECP group was lower than that of the combined group. In group RIPC [(316.97 + 24.25), (322.83 + 44.43) vs (361.85 + 52.38) ng/L, P0.05], there was no significant difference between these two groups [(316.97 + 24.25) vs (322.83 + 44.43) ng/L, P0.05]. conclusion: enhanced extracorporeal counterpulsation and distal ischemic preconditioning could reduce the level of inflammation in the body and improve endothelial function in patients with coronary heart disease, but the combined effect of the two groups was combined. No stronger counterpulsation than a simple enhanced type of counterpulsation.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 賈魁;寇俊杰;;遠(yuǎn)程缺血預(yù)適應(yīng)對心肌保護(hù)作用的研究進(jìn)展[J];中華臨床醫(yī)師雜志(電子版);2012年03期

2 余琴;李新;鄭舒展;熊英;;增強(qiáng)型體外反搏對高血壓患者血管內(nèi)皮功能的影響[J];四川醫(yī)學(xué);2010年10期

3 何小洪,張焰,陳小林,鄭振聲,詹澄揚(yáng),柳俊,伍貴富,方典秋,梁陸光,錢月桃,凌桂芳,戴剛,馮銘U，

本文編號：1959955