| Objective:To observe the changes of exercise tolerance,plasma LP-PLA2 and hs-CRP levels in patients with stable angina pectoris before and after EECP,in order to evaluate the effect of EECP on exercise tolerance in patients with stable angina pectoris and to explore the mechanism of EECP.Methods:This study Included 78 patients with stable angina pectoris who were hospitalized in the cardiovascular department of The Affiliated People's Hospital of Fujian University of traditional Chinese Medicine in January 2016 to February 2017 and with positive electrocardiogram exercise plate test,confirmed coronary artery disease by coronary angiography,and did not revascularization.These patients were randomly divided into 38 patients in the external counterpulsation + conventional drug treatment group(EECP group)and 40 patients in the conventional drug group.Another 30 healthy cases of physical examination center of Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine were selected as blank control.Conventional drug group:aspirin 100mg qd;metoprolol sustained-release tablets 47.5-190mg qd(dose according to the patients'heart rate adjustament);isosorbide mononitrate sustained-release capsules 40mg qd;atorvastatin calcium Tablets 20mg qn;trimetazidine 20mg po tid;if necessary nitroglycerin tablets 0.5mg sublingual administration or nitroglycerin injection 10ug/min intravenous pump;treatment for 6 weeks.For the merger of hypertension,diabetic patients with conventional symptomatic treatment.EECP group was treated with enhanced external counterpulsation once a day on the basis of the same conventional drug therapy as conventional drug group,each 1h,6 days a week,36h for a course of treatment,a total of 6 weeks.Before and after the experiment,we recorded the two groups'data of electrocardiogram exercise plate test(total exercise time,the maximum exercise equi-valent,ST segment down 0.1 mV emergence time and ST segment down amplitude,induced angina cases),levels of serum LP-PLA2 and hs-CRP,which would be compared to find any differentces before and after treatment.Results:(1)Comparison of electrocardiographic exercise plate data:?After 6 weeks of treatment,there were 3 patients with negative treadmill exercise test in the EECP group,and 1 case in the conventional drug group,and all these patients had mild coronary artery disease(The average value of Gensini integral is 19.25).The difference between the two groups was not statistically significant,P>0.05.?The total exercise time and exercise tolerance of EECP group and conventional drug group were significantly higher than those before treatment(P<0.05).The EECP group was significantly higher than that of the conventional drug group(P<0.05).?There was no significant difference in the time of ST segment shift of 0.1mV in the conventional drug group before and after treatment,P>0.05,EECP group' time delay,P<0.05.?The two groups' value of ST segment displacement amplitude after treatment was lower than before,P<0.05;EECP group' value decreased more significantly than the conventional drug group's,P<0.05.?In the EECP group and conventional drug group,there was no significant difference in the number of patients induced angina pectoris by exercise test between before and after treatment,P>0.05.(2)After 6 weeks of treatment,the levels of LP-PLA2 and hs-CRP in the two groups were lower than those before treatment,P<0.05,LP-PLA2 and hs-CRP concentration in the EECP group decreased significantly compared with the conventional drug group,P<0.05.Conclusions:(1)EECP can prolong the total exercise time and improve exercise tolerance of patients with stable angina pectoris,;(2)EECP can reduce the level of plasma Lp-PLA2 and hs-CRP in patients with stable angina pectoris,and play an anti-inflammatory effect. |
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