【摘要】 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。更多还原

【Abstract】 Objective To determine the effects of cuff ischemia training on myocardial ischemia and cardiac function in patients with chronic total occlusion of single-vessel coronary artery disease. Methods 52 patients with chronic total occlusion of single-vessel coronary artery disease were randomly divided into training group and control group,each of 26 cases. All patients were treated with conventional medical treatment,the patients in training group performed six-months training. Vascular endothealial growth factor( VEGF) were determined by enzyme linked immunosorbent assay( ELISA). Single-photon emission computed tomography( SPECT) was used to evaluate myocardial perfusion,ultrasonic cardiogram was used to evaluate left ventricular function. Results After six months of training,the VEGF concentration of training group was significantly higher than that before training and control group,the differences were statistically significant( P < 0. 01); the VEGF concentration difference before and after the training group was not statistically significant( P > 0. 05). The VEGF concentration and total resting SPECT score( SRS) had a high negative correlation. After six months of training,the SPECT SRS of training group was lower than the previous training and control group,LVEF,6min walk test were higher than before training and control group,the differences were statistically significant( P < 0. 01); The difference of SPECT SRS,echocardiography LVEF and 6min walk test before and after training in control group was not statistically significant( P > 0. 05). The heart rate and blood pressure before and after training in control group had no significant changes,the difference was not statistically significant( P > 0. 05). Conclusion Cuff ischemia training may promote myocardial perfusion and left ventricular function in patients with chronic total occlusion of single-vessel coronary artery disease.更多还原