Effect Of External Counterpulsation On The Serum Level Of Homocysteine And C-reactive Protein In Patients With Coronary Heart Disease

Objective:The basic principle of Enhanced External Counterpulsation (EECP) functions as follows:the blood of peripheral artery is driven to regurgitate into the aorta; the diastolic blood pressure is elevated to increase myocardial blood supply and at the same time systolic blood pressure is decreased to moderate cardiac work. MUST-EECP confirmed that70%of the patients with angina pectoris got better and the condition was kept for more than one year, which showed that there must be a deeper mechanism of action in treating coronary heart disease with EECP apart from hemodynamic improvement. This study is to investigate the effect of External Counterpulsation on Homocysteine(HCY) and C-reactive Protein (CRP) in patients with Coronary Heart Disease (CHD), to explore the biological mechanisn of EECP on prevention and treatment of CHD.Methods:100patients with coronary heart disease were randomly divided into ECP treatment group (50cases) and routine treatment group (50cases). Both groups were given standardized medication and ECP treatment group was treated with ECP therapy for60minutes every day in the two periods of treatment of4weeks. Before and after the treatment, the serum concentrations of CRP and HCY were tested to make a statistical analysis of the test by SPSS16.0software. Between groups two independent samples t test were applied and t’ test were applied for heterogeneity of variance. In the group paired t test was applied before and after treatment and the enumeration data were compared with the x2test with inspection level a=0.05.Results:There were no statistical differences in sex, age, previous history, course of disease, indices of blood biochemistry and drug therapy between the two groups. Before treatment there was no statistically significant difference (x2=0.1021, p>0.05)between the two groups of patients with clinical symptoms such as palpitation, chest tightness and so on. After treatment, symptoms improvement rate in EECP group was obviously higher than that in the control group, and the difference was statistically significant (x=5.9925,P<0.05). Before treatment, for the patients with normal serum level there were no significant differences in the serum levels of HCY and CRP between the two groups(P>0.05). After treatment, the rate of the patients with normal serum level of CRP and HCY in the ECP group was significantly higher than that in the control group and the difference was statistically significant (P<0.05). Before treatment, the difference of HCY wasn’t statistically significant for the EECP group and the routine group (t=0.054, P=0.957) and the difference of CRP wasn’t statistically significant for the two groups (t=0.203, P=0.839). There was comparability in the baseline data of the two groups. The difference of HCY in the ECP group before and after the treatment was greater than that in the routine treatment group and the difference was statistically significant (t=16.875, P<0.05). The difference of CRP in the ECP group before and after the treatment was greater than that in the routine treatment group and the difference was statistically significant(t=21.492, P<0.05).Conclusions:EECP can obviously improve the clinical symptoms of the patients with coronary heart disease and decrease the serum levels of HCY and CRP in the patients with coronary heart disease, superior to simple drug treatment. The curative effect of EECP group is better than that of the routine group. The biological mechanism of EECP is partly revealed in its longer benefits for the patients with treatment coronary heart disease. It is shown that EECP is beneficial to the prevention, treatment and rehabilitation of coronary heart disease.