| BackgroundWith the rapid development of economy and the constantly change of human’s living habits,the incidence of CHD around the world has increased continuously and patients are becoming younger day by day,which seriously threatens human health.Unstable angina pectoris(UA)is a vital part of CHD,which can develop into acute myocardial infarction.Studies have shown that RIPC has cardio protective effect and therapeutic effect on UA,but the mechanism is still not completely clear.The principle and mechanism of EECP have been fully studied,and its clinical effects have been extensively realized.In this paper,RIPC was used to intervene patients with UA,EECP is used as a control,so as to evaluate the biological effect of RIPC on UA patients.ObjectiveTo study the biological effects of Remote Ischemic Preconditioning on patients with unstable angina.Methods54 patients with unstable angina pectoris who admitted to our hospital from September2018 to June 2019 were randomly divided into 2 groups: the RIPC group and the contral group.Blood pressure,plasma nitric oxide(no),plasma TNF-α and angina symptom score were selected as the observation indexes.On the basis of standard drug treatment of coronary heart disease,the remote ischemic preconditioning instrument or the enhanced external counterpulsation instrument were used to perform the test.In the RIPC group,the pressure intensity was 200 mm Hg,air was inflated into and deflated out of the cuff for5 min,respectively.Five cycles were performed in one period,the course lasted for 44 min.In the control group,the pressure intensity was 0.030-0.045MPa(about 225-339 mm Hg),30 min.Both procedures were carried out twice a day in the morning and afternoon,lasting for 10 days.The blood pressure(measured during each operation),plasma nitric oxide(no)and plasma TNF-α(measured only during the first and the last operation)were measured before and 10 minutes after the procedure,and the angina scores were evaluated.The costbenefit effect of these two groups were also comparised.Results1.Plasma NO: before the procedurs,the plasma NO level was 45.85±11.98μmol /L and44.27±7.25μmol/L in RIPC and the contral group,respectively;after the procedures,the plasma NO level was 55.40±6.83μmol/L and 59.31±7.29 μmol/L in RIPC and the control group.The plasma NO level was significantly higher in RIPC group than that of the control group(P<0.05).Both groups’ plasma NO level before the procedurs was significantly higher than that after the procedures(P<0.05);2.Plasma TNF-α: before the procedures,the plasma TNF-α level was 22.87±2.91μmol/L and 22.98±2.96μmol/L in RIPC and the control group,respectively;after the procedures,the plasma TNF-α level was 17.82±1.91μmol/L and 16.63±2.8μmol /L in RIPC and the control group,respectively.The plasma TNF-α level was significantly lower in RIPC group than that of the control group(P<0.05).Both groups’ plasma TNF-α level before the procedures was significantly lower than that after the procedures(P<0.05);3.Blood pressure: before the procedures,the SBP was 131.82±11.88 mm Hg and134.87±12.15 mm Hg in RIPC and the control group,respectively;the DBP was 93.44±5.88 mm Hg and 95.47±6.56 mm Hg,respectively;after the procedures,the SBP was 125.63±9.50 mm Hg and 120.03±10.52 mm Hg,respectively,the DBP was 90.85±4.42 mm Hg and91.90±5.19 mm Hg,respectively.The SBP was significantly higher in RIPC group than that of the control group(P<0.05).But the difference of DBP in both groups indicated non statistical significance(P>0.05).For the two groups,the SBP decreased after the procedures,the differences showed statistical significance(P<0.05);4.Angina questionnaire: before the procedures,the angina questionnaire level was13.57±2.27 and 13.25±1.63 in RIPC and EECP group,respectively;after the procedures,the angina questionnaire level was 9.43±2.23 and 7.26± 3.34 in RIPC and EECP group,respectively.The angina questionnaire level was significantly higher in RIPC group than that of EECP group(P<0.05).Both groups’ angina questionnaire level before the procedures was significantly lower than that after the procedures(P<0.05);5.Cost-benefit analysis results: when patients receive the treatment for more than 18 days,RIPC is more affordable.Conclusion1.RIPC can reduce the SBP level of UA patients,but the DBP level have no obvious change;2.RIPC can raise the plasma NO level of the patients with UA;3.RIPC can reduce the plasma TNF-α level of the patients with UA;4.RIPC reduce the UA patients’ angina questionnaire level;5.RIPC is of predominant Cost-Benefit effect. |
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