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目的观察袖带法缺血训练对单支冠状动脉慢性完全闭塞病变患者心肌缺血及左心室功能的影响。方法将52例单支冠状动脉慢性完全闭塞病变患者随机分为训练组和对照组各26例,2组均给予药物治疗,在此基础上对训练组患者训练6个月。于训练前后抽取患者外周血,ELISA法检测外周血血管内皮生长因子(VEGF)的浓度,单光子发射计算机断层显像SPECT仪检测心肌灌注,超声心动图检测左心室功能。结果训练组经6个月训练,VEGF浓度明显高于训练前及对照组,差异均有统计学意义(P<0.01);对照组训练前后VEGF浓度差异无统计学意义(P>0.05)。VEGF浓度与SPECT总静息评分(SRS)高度负相关。训练组经6个月训练,SPECT SRS低于训练前及对照组,LVEF、6min步行试验均高于训练前及对照组,差异均有统计学意义(P<0.01);对照组训练前后SPECT SRS、超声心动图LVEF及6min步行试验比较差异均无统计学意义(P>0.05)。训练组训练时心率及血压未见明显变化,差异均无统计学意义(P>0.05)。结论袖带法缺血训练可显著改善单支冠状动脉慢性完全闭塞患者的心肌缺血,进而改善患者的左心室功能。
Objective To observe the effect of cuff method ischemic training on myocardial ischemia and left ventricular function in patients with chronic coronary artery occlusion. Methods Totally 52 patients with chronic coronary artery occlusive disease were randomly divided into training group (26 cases) and control group (26 cases). Both groups were given drug therapy. On the basis of this, 6 months training group were trained. Peripheral blood samples were collected before and after training. ELISA was used to detect the concentration of vascular endothelial growth factor (VEGF) in the peripheral blood. Single photon emission computed tomography (SPECT) was used to detect myocardial perfusion. Echocardiography was used to detect left ventricular function. Results The training group was trained for 6 months and the VEGF concentration was significantly higher than that before training and the control group (P <0.01). There was no significant difference in VEGF concentration before and after training in the control group (P> 0.05). The concentration of VEGF was highly negatively correlated with the total resting SPECT score (SRS). The training group after training for 6 months, SPECT SRS lower than before training and control group, LVEF, 6min walk test were higher than before training and control group, the difference was statistically significant (P <0.01); control group before and after training SPECT SRS , Echocardiography LVEF and 6min walk test showed no significant difference (P> 0.05). Training group training heart rate and blood pressure no significant change, the difference was not statistically significant (P> 0.05). Conclusion Cuff method of ischemic training can significantly improve myocardial ischemia in patients with chronic complete occlusion of single coronary artery and further improve left ventricular function in patients.