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目的 探讨增强型体外反搏对冠心病患者运动心功能的影响。方法 6 1例确诊冠心病的患者随机分为体外反搏治疗观察组 (2 9例 )和药物治疗对照组 (32例 ) ,观察组在常规药物治疗的基础上接受增强型体外反搏治疗36d(1h d) ,对照组接受常规药物治疗相同天数 ;分别于治疗前后给患者行平板运动试验。结果 治疗后总运动时间 ,观察组由 (7.6± 3.3)min增加至 (9.1± 3.9)min ,对照组由 (9.1± 3.7)min增加至 (9.4± 3.5 )min ,观察组与对照组比较P =0 .0 2 9;做功当量 (METs) ,观察组 (6 .1± 2 .8,7.9± 2 .4 )比对照组 (5 .8± 2 .8,6 .1± 2 .8)增加 (P =0 .0 36 ) ;缺血程度 (以ST段下降毫米数表示 ) (mm) ,观察组 (2 .2± 1.3,1.7± 1.3)比对照组 (1.4± 1.0 ,1.6± 1.1)明显减轻 (P =0 .0 0 2 ) ;缺血范围 (以缺血导联总数表示 ) ,观察组 (4.1± 2 .3,3.1± 2 .3)比对照组 (2 .7± 2 .4 ,3.3± 2 .4 )减少 (P =0 .0 0 1) ;缺血耐受能力二组差异无统计学意义 (P =0 .0 88)。结论 增强型体外反搏在较短时间内可提高冠心病患者的运动心功能 ,并使由运动诱发的心肌缺血的范围和程度减少。
Objective To investigate the effect of enhanced EECP on exercise heart function in patients with coronary heart disease. Methods Sixteen patients with confirmed coronary heart disease were randomly divided into observation group (29 cases) and drug treatment control group (32 cases). The observation group received enhanced EECP on the basis of routine drug therapy for 36 days (1h d), the control group received the same number of days of conventional drug treatment; patients were treadmill exercise test before and after treatment. Results The total exercise time in the observation group increased from (7.6 ± 3.3) min to (9.1 ± 3.9) min in the observation group and from (9.1 ± 3.7) min to (9.4 ± 3.5) min in the observation group compared with the control group = 0. 0 2 9; METs, the observation group (6 .1 ± 2 .8, 7.9 ± 2 .4) than the control group (5 .8 ± 2 .8,6 .1 ± 2 .8) (2.3 ± 1.3, 1.7 ± 1.3) in the observation group (1.4 ± 1.0, 1.6 ± 1.1) compared with the control group (P <0.05) ) (P = 0.002). The extent of ischemia (indicated by the total number of ischemic leads) in the observation group (4.1 ± 2.3, 3.1 ± 2.3) was significantly lower than that in the control group (2.7 ± 2 .4, 3.3 ± 2. 4) (P = 0.010). There was no significant difference in ischemic tolerance between the two groups (P = 0.088). Conclusions Enhanced external counterpulsation can improve cardiac function in patients with coronary heart disease in a short period of time and reduce the range and extent of myocardial ischemia induced by exercise.