2024 年第 9 期 第 19 卷

增强型体外反搏治疗心绞痛伴心功能不全的临床效果及对患者血清N末端B型脑钠肽前体水平的影响

The clinical effect of enhanced external counterpulsation in the treatment of angina pectoris with cardiac insufficiency and its influence on serum N-terminal pro-brain natriuretic peptide level

作者：伍仙凤1解蓓2

英文作者：Wu Xianfeng1 Xie Bei2

单位：1湖北省荆门市人民医院心血管内科，荆门448000；2湖北省荆门市人民医院心脏康复中心，荆门448000

英文单位：1Department of Cardiovascular Medicine the People′s Hospital of Jingmen Hubei Province Jingmen 448000 China; 2Heart Rehabilitation Center the People′s Hospital of Jingmen Hubei Province Jingmen 448000 China

关键词：心绞痛；心功能不全；增强型体外反搏；N末端B型脑钠肽前体

英文关键词：Anginapectoris;Cardiacinsufficiency;Enhancedexternalcounterpulsation;N-terminalpro-brainnatriureticpeptide

• 摘要：

• 目的 探讨增强型体外反搏治疗心绞痛伴心功能不全的临床效果及对患者血清N末端B型脑钠肽前体（NT-proBNP）水平的影响。方法 选取2022年4月至2023年4月于湖北省荆门市人民医院诊治的心绞痛伴心功能不全患者82例，按随机数字表法分成观察组与对照组，每组41例。对照组均给予常规药物治疗；观察组在对照组基础上给予增强型体外反搏治疗。比较2组治疗前后心绞痛分级、心功能指标［左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）、左心室舒张末期内径（LVEDD）］、实验室检查指标［NT-proBNP、高敏C反应蛋白（hs-CRP）、人半乳糖凝集素3(Galectin-3)］和心血管不良事件发生情况。结果 治疗后观察组心绞痛分级情况优于对照组，差异有统计学意义（Z=-6.933，P＜0.001）。治疗后，2组LVEF均高于治疗前，LVFS、LVEDD均低于治疗前，且观察组LVEF高于对照组，LVFS、LVEDD均低于对照组，差异均有统计学意义（均P＜0.05）。治疗后，2组患者NT-proBNP、hs-CRP、Galectin-3均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P＜0.05）。观察组心血管不良事件发生率低于对照组［4.9%（2/41）比22.0%（9/41）］，差异有统计学意义（P=0.023）。结论 心绞痛伴心功能不全患者采用增强型体外反搏治疗效果显著，能够有效改善心绞痛症状并提高心功能，降低血清NT-proBNP及炎症因子水平。

• Objective To investigate the clinical effect of enhanced external counterpulsation in the treatment of angina pectoris with cardiac insufficiency and its influence on serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level. Methods A total of 82 patients with angina pectoris and cardiac insufficiency who were diagnosed and treated in the People′s Hospital of Jingmen, Hubei Province from April 2022 to April 2023 were selected as the research objects. According to the random number table method, they were divided into observation group and control group, with 41 cases in each group. The control group was given conventional drug treatment. The observation group was treated with enhanced external counterpulsation on the basis of the control group. The grading of angina pectoris, cardiac function indicators ［left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end diastolic diameter (LVEDD)］, laboratory testing indicators ［NT-proBNP, high-sensitivity C-reactive protein (hs-CRP), human galactose agglutinin 3 (Galectin-3)］ before and after treatment, and incidence of cardiovascular adverse events between two groups were compared. Results After treatment, the classification of angina pectoris in the observation group was better than that in the control group (Z=-6.933, P＜0.001). After treatment, LVEF of the two groups were higher than those before treatment, LVFS and LVEDD were lower than those before treatment, LVEF of the observation group was higher than that of the control group, LVFS and LVEDD were lower than those of the control group(all P＜0.05). After treatment, the NT-proBNP, hs-CRP, and Galectin-3 levels in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P＜0.05). The incidence of adverse cardiovascular events in the observation group was lower than that in the control group ［4.9%(2/41) vs 22.0%(9/41)］(P=0.023). Conclusion The effect of enhanced external counterpulsation in the treatment of patients with angina pectoris and cardiac insufficiency is significant, which can effectively improve the symptoms of angina pectoris and cardiac function, and reduce the levels of NT-proBNP and inflammatory factors.