增强型体外反搏在心脏康复中的研究进展

doi:10.3760/cma.j.issn.1007-1245.2024.12.001

摘要/Abstract

摘要：

心脏康复是一种综合性的治疗方法，有助于减少心肌缺血风险，提升患者的生活质量。此外，心脏康复还能缓解患者负性情绪，帮助患者提升自我认知和情绪调节能力，促进心理健康。体外反搏作为心脏康复的一种重要手段，通过增加冠状动脉的灌注压及提高心血管系统的功能，降低罹患心血管疾病风险和再住院率等预后指标，对患者的远期生存和生活质量有积极的影响。该文将从原理、机制及临床应用几个方面探讨增强型体外反搏在心脏康复中的研究进展。

关键词:

增强型体外反搏, 心脏康复, 冠心病, 心绞痛, 研究进展

Abstract:

Cardiac rehabilitation is a comprehensive treatment that helps to reduce the risk of myocardial ischemia and improve the patients' quality of life. In addition, cardiac rehabilitation can also relieve the patients' negative emotions, help the patients improve self-cognition and emotional regulation ability, and promote the mental health. As an important means of cardiac rehabilitation, external counterpulsation has a positive impact on patients' long-term survival and quality of life by increasing coronary artery perfusion pressure, improving the function of cardiovascular system, and reducing the risk of cardiovascular disease and the rate of re-hospitalization and other prognostic indicators. This article discusses the research progress of enhanced external counterpulsation in cardiac rehabilitation from several aspects of clinical application and mechanism.

Key words:

Enhanced external counterpulsation, Cardiac rehabilitation, Coronary heart disease, Angina pectoris, Research progress

沈沽灼陈艳丽李秀芬.

增强型体外反搏在心脏康复中的研究进展 [J]. 国际医药卫生导报, 2024, 30(12): 1937-1941.

Shen Guzhuo, Chen Yanli, Li Xiufen.

Research progress of enhanced external counterpulsation in cardiac rehabilitation [J]. International Medicine and Health Guidance News, 2024, 30(12): 1937-1941.

参考文献

[1] Varghese MS, Song Y, Xu J,et al. Availability and use of in-person and virtual cardiac rehabilitation among US medicare beneficiaries: a post-pandemic update[J]. J Cardiopulm Rehabil Prev, 2023,43(4):301-303.DOI: 10.1097/HCR.0000000000000803.
[2] Wang Q, Hao J, Jiang W,et al. Enhanced external counterpulsation increases coronary flow reserve in coronary microvascular disease[J]. Saudi Med J,2023,44(12):1277-1282.DOI: 10.15537/smj.2023.44.12. 20230427.
[3] Bondesson S, Pettersson T, Ohlsson O,et al. Effects on blood pressure in patients with refractory angina pectoris after enhanced external counterpulsation[J]. Blood Press, 2010,19(5):287-294.DOI: 10.3109/08037051003794375.
[4] 顾迎春,韩凌,李杨,等. 增强型体外反搏对心血管血流动力学影响的研究进展[J]. 中西医结合心脑血管病杂志,2023,21(22):4157-4161. DOI:10.12102/j.issn.1672-1349. 2023.22.017.
[5] 杨海燕,刘爽,卢江曼. 增强型体外反搏治疗静息心率增快的老年高血压临床效果观察[J]. 山东医药,2023,63(23):50-54. DOI:10.3969/j.issn.1002-266X.2023.23.012.
[6] 王媛媛,刘芳芳,曹爱红,等. 二维斑点追踪超声心动图评估增强型体外反搏对老年冠状动脉慢血流患者左心室功能的影响[J]. 中华老年医学杂志,2023,42(10):1161-1165. DOI:10.3760/cma.j.issn.0254-9026.2023.10.003.
[7] 钟玲,邢军,赵保礼,等. 增强型体外反搏联合中强度间歇训练对冠心病心肺储备能力及运动耐力的影响[J]. 中国康复医学杂志,2023,38(4):478-484. DOI:10.3969/j.issn.1001- 1242.2023.04.007.
[8] 梁建文,李小玲,吴奋生,等. 增强型体外反搏治疗对冠心病支架术后患者心肌微循环功能的影响[J]. 岭南心血管病杂志,2018,24(3):253-257,271. DOI:10.3969/j.issn.1007- 9688.2018.03.02.
[9] 孙刚,吴宇红,张学芳,等. 增强型体外反搏对不稳定型心绞痛患者经皮冠状动脉介入治疗后血流的短期效应与安全性[J]. 岭南心血管病杂志,2018,24(1):9-13. DOI:10.3969/j.issn.1007-9688.2018.01.03.
[10] Du J, Peng J, Shen X,et al. Enhanced external counterpulsation treatment regulates blood flow and wall shear stress metrics in femoral artery: an in vivo study in healthy subjects[J]. J Biomech, 2023,159:111797.DOI: 10.1016/j.jbiomech.2023.111797.
[11] 张辉,赵东升,王云豹. 增强型体外反搏通过调节endocan-1和vaspin水平改善血管内皮功能障碍[J]. 中国动脉硬化杂志,2022,30(2):141-146. DOI:10.3969/j.issn.1007-3949.2022.02.010.
[12] Wang Z, Yao C, Huang L,et al. Enhanced external counterpulsation improves dysfunction of forearm muscle caused by radial artery occlusion[J]. Front Cardiovasc Med, 2023,10:1115494.DOI: 10.3389/fcvm.2023.1115494.
[13] Adams JA, Uryash A, Lopez JR,et al. The endothelium as a therapeutic target in diabetes: a narrative review and perspective[J]. Front Physiol, 2021,12:638491.DOI: 10.3389/fphys.2021.638491.
[14] 王宝莹,段继豪. 增强型体外反搏联合运动疗法对闭塞性冠状动脉疾病患者侧支循环的影响[J]. 中国药物滥用防治杂志,2022,28(12):1768-1771. DOI:10.15900/j.cnki.zylf1995.2022.12.012.
[15] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等. 冠心病心脏康复基层指南(2020年)[J]. 中华全科医师杂志,2021,20(2):150-165. DOI:10.3760/cma.j.cn114798- 20201124-01187.
[16] Virani SS, Newby LK, Arnold SV,et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: a report of the American heart Association/American college of cardiology joint committee on clinical practice guidelines[J]. Circulation, 2023,148(9):e9-e119.DOI: 10.1161/CIR.0000000000001168.
[17] Verhemel S, Jones D A, Weeraman D,et al.The impact of non-pharmacological therapies on cardiovascular outcomes in patients with refractory angina: a systematic review and meta-analysis of randomized controlled trials[J].European Heart Journal,2021,42(Supplement_1):Supplement_1.DOI:10.1093/eurheartj/ehab724.1071.
[18] Nishimoto Y, Inohara T, Kohsaka S,et al. Changing trends in mechanical circulatory support use and outcomes in patients undergoing percutaneous coronary interventions for acute coronary syndrome complicated with cardiogenic shock: insights from a nationwide registry in Japan[J]. J Am Heart Assoc, 2023,12(23):e031838.DOI: 10.1161/JAHA.123.031838.
[19] Knuuti J, Wijns W, Saraste A,et al. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes[J]. Eur Heart J, 2020,41(3):407-477.DOI: 10.1093/eurheartj/ehz425.
[20] Rayegani SM, Heidari S, Maleki M,et al. Safety and effectiveness of enhanced external counterpulsation (EECP) in refractory angina patients: a systematic reviews and meta-analysis[J]. J Cardiovasc Thorac Res, 2021,13(4):265-276.DOI: 10.34172/jcvtr.2021.50.
[21] Shaker SR, Al-Amran F, Fatima G,et al. Trimetazidine improves the outcome of EECP therapy in patients with refractory angina pectoris[J]. Med Arch, 2020,74(3):199-204.DOI: 10.5455/medarh.2020.74.199-204.
[22] Xu L, Cui M, Zhao W. The effect of EECP on ischemic heart failure: a systematic review[J]. Curr Cardiol Rep, 2023,25(10):1291-1298. DOI: 10.1007/s11886-023-01943-1.
[23] Sahebjami F, Madani FR, Komasi S,et al. Refractory angina frequencies during 7 weeks treatment by enhanced external counterpulsation in coronary artery disease patients with and without diabetes[J]. Ann Card Anaesth, 2019,22(3):278-282.DOI: 10.4103/aca.ACA_86_18.
[24] Zeng CM, Zhao YM, Zhong XJ,et al. Reduction in risk of contrast-induced nephropathy in patients with chronic kidney disease and diabetes mellitus by enhanced external counterpulsation[J]. Front Endocrinol (Lausanne), 2022,13:973452. DOI: 10.3389/fendo.2022. 973452.
[25] 何晓琳,刘柏明.体外反搏治疗心脏X综合征的临床疗效观察[J].人人健康, 2022(16):66-68.
[26] 杨长贵,田华伟,张新霞,等. EECP在几种常见心脑血管疾病中的研究进展[J]. 国际医药卫生导报,2019,25(13):2065-2068. DOI:10.3760/cma.j.issn.1007-1245.2019. 13.016.
[27] Liu H, Liang H, Yu X,et al. Enhanced external counterpulsation modulates the heartbeat evoked potential[J]. Front Physiol, 2023 ,14:1144073.DOI: 10.3389/fphys.2023.1144073.
[28] Liu H, Liang H, Yu X,et al. A study on the immediate effects of enhanced external counterpulsation on physiological coupling[J]. Front Neurosci, 2023,17:1197598.DOI: 10.3389/fnins.2023.1197598.
[29 Zhang Q, Zhang Y, Hao L,et al. A personalized 0D-1D model of cardiovascular system for the hemodynamic simulation of enhanced external counterpulsation[J]. Comput Methods Programs Biomed, 2022 ,227:107224.DOI: 10.1016/j.cmpb.2022.107224.
[30] 郑立娇,王苗,丁胜华. 增强型体外反搏联合复方丹参滴丸对不稳定型心绞痛病人心脏自主神经功能及血清Hcy、内皮抑素表达的影响[J]. 中西医结合心脑血管病杂志,2022,20(14):2591-2595. DOI:10.12102/j.issn.1672-1349. 2022.14.022.
[31] Zhang X, Yao C, Xiao Q,et al. Enhanced external counterpulsation: a new method to alleviate contrast-induced acute kidney injury[J]. Contemp Clin Trials, 2022,113:106653.DOI: 10.1016/j.cct.2021.106653.
[32] Zhao M, Huang Y, Li L,et al. Enhanced external counterpulsation efficacy on exercise endurance in COPD patients and healthy subjects: a pilot randomized clinical trial[J]. Int J Chron Obstruct Pulmon Dis, 2020,15:25-31.DOI: 10.2147/COPD.S225566.
[33] Lin L, Zhu W, Ma N,et al. Evaluation of enhanced external counterpulsation therapy for nonarteritic anterior ischemic optic neuropathy[J]. BMC Ophthalmol, 2020,20(1):236.DOI: 10.1186/s12886-020-01509-7.
[34] Soubh N, Hillmeister P, Buschmann E,et al. Tolerability safety and effectiveness of enhanced external counterpulsation versus individual shear rate therapy in patients with lower extremity atherosclerotic disease: a prospective pilot clinical trial[J]. Acta Physiol (Oxf), 2023,237(3):e13913.DOI: 10.1111/apha.13913.
[35] Yin Y, He Q, Zhang R,et al. Predictors of adherence of enhanced external counterpulsation in patients with coronary heart disease after discharge: a mixed-methods study[J]. Front Cardiovasc Med, 2022,9:1005958.DOI: 10.3389/fcvm.2022.1005958.
[36] Rezapour A, Naghdi S, Ghiasvand H,et al. A systematic review on the economic evaluations evidence of enhanced external counter-pulsation (EECP) for managing chronic stable angina[J]. Med J Islam Repub Iran, 2022,36:100.DOI: 10.47176/mjiri.36.100.