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目的:探讨增强型体外反搏治疗进展性卒中对早期动脉粥样硬化斑块的影响。方法:根据随机数字表法将130例进展性卒中患者分为治疗组与对照组,每组各65例,2组均给予常规药物治疗,在此基础上治疗组加用增强型体外反搏治疗。结果:治疗组与对照组治疗前的颈动脉内中膜厚度(IMT)分别为(1.89±0.31)mm和(1.88±0.42)mm,治疗后分别为(1.18±0.56)mm和(1.45±0.34)mm,治疗后治疗组的颈动脉IMT低于对照组(P<0.05)。2组患者治疗后的斑块负荷和斑块面积较治疗前均有减少(P<0.05),且治疗后治疗组的斑块负荷、斑块面积均低于对照组(P<0.05)。2组治疗后的血清P-选择素和纤维蛋白原含量较治疗前均有下降(P<0.05),且治疗后治疗组的血清P-选择素和纤维蛋白原含量均明显低于对照组(P<0.05)。2组治疗后斑块性质均呈现硬化趋势,与治疗前比较差异有统计学意义(P<0.05),且治疗后治疗组的斑块性质好于对照组(P<0.05)。结论:增强型体外反搏治疗进展性卒中能有效发挥改善凝血与纤溶功能的作用,防止易损斑块的形成,降低斑块负荷、斑块面积和颈动脉IMT,从而发挥治疗作用。
Objective: To investigate the effect of enhanced external counterpulsation on early atherosclerotic plaques in patients with advanced stroke. Methods: According to the random number table method, 130 patients with progressive stroke were divided into treatment group and control group, 65 cases in each group, 2 groups were given conventional drug treatment, on this basis, the treatment group plus enhanced external counterpulsation . Results: The carotid intima - media thickness (IMT) of the treatment group and the control group before treatment were (1.89 ± 0.31) mm and (1.88 ± 0.42) mm, respectively, and were 1.18 ± 0.56 and 1.45 ± 0.34 ) mm, after treatment, the carotid IMT of the treatment group was lower than that of the control group (P <0.05). The plaque burden and plaque area of the two groups were decreased after treatment (P <0.05), and the plaque burden and plaque area of the two groups were lower than that of the control group after treatment (P <0.05). The levels of serum P-selectin and fibrinogen decreased after treatment in both groups (P <0.05), and the levels of P-selectin and fibrinogen in the treatment group were significantly lower than those in the control group P <0.05). The plaque characteristics of both groups showed hardening tendency, which was significantly different from that before treatment (P <0.05). The plaque quality of the treatment group was better than that of the control group after treatment (P <0.05). Conclusions: EECP can improve the function of coagulation and fibrinolysis in the treatment of advanced stroke, prevent the formation of vulnerable plaque and reduce the plaque load, plaque area and carotid IMT, and thus play a therapeutic role.