周国强黄宗青张志肖剑伟张娟王玉光

·论 著·

增强型体外反搏对缺血性脑卒中患者超敏C反应蛋白和内皮素1的影响☆

周国强*黄宗青*张志*肖剑伟*张娟*王玉光*

目的探讨增强型体外反搏治疗（enhanced external counterpulsation，EECP）对缺血性脑卒中患者超敏C反应蛋白（hs-CRP）和内皮素1（ET-1）的影响，为缺血性脑卒中的二级预防提供进一步的临床证据。方法选取缺血性脑卒中住院患者共187例，EECP治疗组95例，对照组92例，治疗组予常规治疗加上36 h的EECP治疗，对照组予常规治疗，分别比较两组在EECP治疗前、治疗36 h后、治疗后1个月hs-CRP及ET-1的差别。结果与治疗前相比，治疗组hs-CRP、ET-1的血清浓度在EECP治疗后均显著减低，（hs-CRP下降60.1%、ET-1下降40.9%），P值均小于0.05。与对照组比较，治疗组在EECP治疗后hs-CRP、ET-1的浓度均显著减低，（hs-CRP下降41.3%、ET-1下降24.3%），P值均小于0.05。治疗后1个月，与对照组比较，治疗组ET-1的浓度明显减低，（43.8%vs 31.8%），P＜0.05。治疗后1个月，治疗组hs-CRP的浓度与对照组比较无明显差异，P＞0.05，无统计学意义。结论通过EECP治疗，缺血性脑卒中患者的hs-CRP及ET-1血清水平显著下降，且作用持久，EECP治疗可以抑制动脉粥样硬化进程。

增强型体外反搏 超敏C反应蛋白 内皮素1缺血性脑卒中

【Abstract】Objectives To explore the effects of enhanced external counterpulsation（EECP）on the serum level of C-reactive protein and endothelin-1 in patients with cerebral ischemic stroke，to provide clinical evidence for the treatment and secondary prevention of patients with cerebral ischemic stroke.Methods Total 187 patients with ischemic stroke were enrolled measure the serum level of C-reactive protein and endothelin-1，before EECP，after36 hours EECP，and one-month after EECP.Then contrast the difference of these indicators.Result After treatment，the serum levels of C-reactive protein and endothelin-1 in EECP group were obviously decrease and the difference was statistically significant（hs-CRP 60.1%vs.ET-1 40.9%，P＜0.05）.After treatment，the serum levels of C-reactive protein and endothelin-1 in EECP group were obviously decrease than that in the control group and the difference was statistically significant（hs-CRP 41.3%vs.ET-1 24.3%，P＜0.05）.One-month after EECP，the serum level of endothelin-1 in EECP group was obviously decrease than that in the control group（43.8%vs.31.8%，P＜0.05）.One-month after EECP，there was no significant difference in the serum levels of C-reactive protein between the two groups（P＞0.05）.Conclusion EECP can obviously reduce the serum levels of C-reactive protein and endothelin-1 in the patients with ischemic stroke，which indicates that EECP can slow atherosclerotic process.

【Key words】Enhanced external counterpulsation Endothelin-1 C-reactive protein Cerebral ischemic stroke

增强型体外反搏（enhanced external counterpulsation，EECP）是当今国际上冠心病治疗中一项有效、安全、廉价、无创的物理循环辅助治疗。EECP具有提高血流切应力、增加组织器官的血流灌注、促进缺血组织侧支循环开放和血管新生、调节血管内皮细胞分泌功能、抑制动脉粥样硬化的发生与进展的作用。近年来，临床实践证实EECP对缺血性脑血管病的治疗和康复亦具有良好疗效［1-2］。2013年美国AHA/ASA以Ⅱb级别推荐将EECP作为增加脑血流灌注的治疗手段［3］。……