【摘要】 以往认为体外反搏治疗的主要作用机制是通过产生双脉动血流,以舒张期增压的方式提高心脏灌注。近年来血管生物学方面的研究表明,体外反搏还通过加速动脉系统血流速度,提高血管内皮系统的血流切应力,并通过一系列血管内膜保护相关的调控机制,有效促进内皮细胞结构和功能的修复,对抗动脉粥样硬化的进展。现简要地复习近年来的有关研究工作,从调控血管张力和血管活性物质、改善血流介导的血管舒张和动脉僵硬度、抑制动脉内膜增殖、降低循环促炎物质和促进体内内皮祖细胞动员等方面,初步阐述提高血流切应力改善内皮功能这一体外反搏治疗作用的新机制。更多还原

【Abstract】 The primary mechanism of action of enhanced external counterpulsation(EECP) was previously thought to be merely hemodynamic,namely,that EECP generates bi-pulsatile blood flow,and through diastolic augmentation increases coronary perfusion during diastole.Recent advances in vascular biology reveal that EECP accelerates blood flow in the arterial system,thus increasing endothelial shear stress,and subsequently through complex vasculo-endothelial protective mechanisms,restores the structural and functional integrity of endothelium,and ultimately antagonizes the development of atherosclerosis.This review briefly summarizes recent clinical and research results concerning the shear stress-mediated endothelium-protective benefit of EECP,with emphasis on its favorable effects on vascular tone and vasoactive substances,flow-mediated dilatation and arterial stiffness,arterial intimal hyperplasia,circulatory pro-inflammatory factors,and circulatory endothelial progenitor cells.更多还原