探究增强型体外反搏对冠心病慢性心功能不全合并糖耐量异常患者临床疗效观察

To Explore the Clinical Effect of Enhanced External Counterpulsation on Patients with Chronic Heart Dysfunction Combined with Abnormal Glucose Tolerance

摘要: 目的：探究体外反搏治疗冠心病慢性心功能不全合并糖耐量患者临床疗效观察。方法：选取2020年1月至2022年12月于青岛大学医学院附属心血管医院住院的64名冠心病心慢性功能不全合并糖耐量异常为研究对象，依据治疗方法差异分为实验组和对照组，每组各32人。对照组选用常规药物治疗，试验组在常规药物治疗的基础上联合增强型体外反搏(EECP)，对比两组试验前后临床症状缓解情况、6分钟步行试验(6 MWT)、尿微量白蛋白(尿MAU)、pro-BNP、左室射血分数(LVEF%)、左心室舒张末期内径(LVEDD)、肌酐(sCr)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)的变化。结果：试验组临床症状缓解总有效率90.625%，对照组临床症状缓解总有效率75%，试验组6 MMWD、LVEF%增高，且试验组优于对照组，差异有统计学意义(P < 0.05)；试验组尿MAU、LVEDD、pro-BNP、sCr、FBG下降，且试验组下降优于对照组，差异有统计学意义(P < 0.05)；对照组及实验组治疗后HbAlc均下降，但两组数据无明显差异(P > 0.05)。结论：增强型体外反搏可改善冠心病慢性心功能不全合并糖耐量异常患者临床症状，可改善心功能、肾功能，可降低患者血糖及尿微量白蛋白，减轻对血管内皮细胞损伤，值得推广应用。

Abstract: Objective: To explore the clinical efficacy of external counterpulsation in the treatment of patients with chronic coronary heart dysfunction combined with glucose tolerance. Methods: A total of 64 patients with chronic cardiac insufficiency combined with abnormal glucose tolerance who were hospitalized in the Cardiovascular Hospital Affiliated to Qingdao University Medical College from January 2020 to December 2022 were selected as the study objects, and were divided into experi-mental group and control group according to the differences in treatment methods, with 32 pa-tients in each group. The control group was treated with conventional drugs, and the experimental group was combined with enhanced external counterpulsation (EECP) on the basis of conventional drugs. The changes of clinical symptom relief, 6-minute walking test (6 MWT), urinary microalbu-min (urinary MAU), pro-BNP, left ventricular eject fraction (LVEF%), left ventricular end-diastolic inner diameter (LVEDD), creatinine (sCr), fasting blood glucose (FBG) and glycated hemoglobin (HbAlc) before and after the two groups were compared. Results: The total effective rate of clinical symptom relief in the experimental group was 90.625%, the total effective rate of clinical symptom relief in the control group was 75%, the 6 MMWD and LVEF% in the experimental group were in-creased, and the difference was statistically significant (P < 0.05); Urinary MAU, LVEDD, pro-BNP, sCr and FBG decreased in test group, and the decrease in test group was better than that in control group, the difference was statistically significant (P < 0.05); HbAlc decreased after treatment in both control group and experimental group, but there was no significant difference between the two groups (P > 0.05). Conclusion: Enhanced extracorporeal counterpulsation can improve the clinical symptoms of patients with chronic cardiac insufficiency complicated with abnormal glucose toler-ance, improve cardiac function and renal function, reduce blood sugar and urinary microalbumin, and reduce the damage to vascular endothelial cells, which is worthy of popularization and applica-tion.