增强型体外反搏对慢性心力衰竭患者心功能指标的影响

Effect of enhanced external counter pulsation therapy on cardiac function in chronic heart failure patients

摘要:

目的 观察增强型体外反搏(EECP)装置应用于慢性心力衰竭(CHF)患者后对心功能指标的影响并评价其安全性。方法 选择2015年1月至2017年1月在广东省江门市中心医院心血管内科就诊的CHF患者240例,按随机数字表法将240例患者随机分为2组:EECP治疗组和对照组,每组120例。2组均按照指南常规药物治疗,EECP治疗组在对照组的基础上加行EECP 治疗。观察2组治疗前后心率、6 min步行试验结果、脑钠肽(BNP)、左室射血分数(LVEF)及Tei指数变化,并比较不良反应发生率。采用SPSS 16.0软件进行数据处理。根据数据类型,组间比较采用t检验或χ²检验。结果 与治疗前相比,2组患者经过治疗后的心率、6 min步行距离、BNP水平、LVEF及Tei指数均得到显著改善(P＜0.05)。治疗后,与对照组相比,EECP治疗组的心率[(76.4±4.5) vs(80.7±5.7)次/min]、BNP[(1309.0±1497.2) vs(2196.1±2586.6)pg/ml]、Tei指数[(0.59±0.10) vs(0.62±0.11)]均显著下降,而6 min步行距离[(446.20±31.92) vs(407.69±34.80)m]及LVEF[(47.9±2.8)% vs(47.1±3.5)%]均显著增加(P＜0.05)。2组不良反应发生率差异无统计学意义(5.8% vs 6.7%,P＞0.05)。结论 体外反搏治疗可以改善部分CHF患者的心功能指标。

Abstract:

Objective To observe the efficacy and safety of enhanced external counter pulsation (EECP) therapy on cardiac function of patients with chronic heart failure (CHF). Methods A total of 240 CHF patients admitted in our department from January 2015 to January 2017 were recruited in this study. The patients were randomly divided into EECP group and control group, with 120 patients in each group. The patients of both groups were routinely treated according to the guidelines, and those from the EECP group were given EECP therapy. Heart rate, 6-min walking test, brain natriuretic peptide (BNP) level, left ventricular ejection fraction (LVEF) and Tei index were measured before and after treatment, and the results and incidences of adverse reactions were compared between the 2 groups. SPSS statistics 16.0 was used to perform the statistical analysis. Student’s t test or Chi-square test was employed for comparison between groups according to data types. Results Heart rate, 6-min walking distance, BNP level, LVEF and Tei index were improved in both groups after treatment (P<0.05). Compared with the control group, the EECP group showed significantly lower heart rate [(76.4±4.5) vs (80.7±5.7) beats/min], BNP level [(1309.0±1497.2) vs (2196.1±2586.6) pg/ml], and Tei index [(0.59±0.10) vs (0.62±0.11)], but prolonged 6-min walking distance [(446.20±31.92) vs (407.69±34.80) m] and increased LVEF [(47.9±2.8)% vs (47.1±3.5)%] after treatment (P<0.05). But no difference was seen in the adverse reactions between 2 groups (5.8% vs 6.7%, P>0.05). Conclusion EECP therapy improves the cardiac function in CHF patients.