体外心脏震波治疗老年冠心病患者的疗效和安全性分析

被引:16
作者
刘保逸 [1 ]
李文婵 [2 ]
张瑞生 [3 ]
陈聪霞 [2 ]
姚稚明 [2 ]
何青 [1 ]
机构
[1] 北京协和医学院研究生院
关键词
冠心病; 放射性核素显像; 体外心脏震波;
D O I
暂无
中图分类号
R541.4 [冠状动脉(粥样)硬化性心脏病(冠心病)];
学科分类号
摘要
目的探讨体外心脏震波系统(CSWT)治疗老年冠心病患者的有效性和安全性。方法 11例顽固性心绞痛的老年冠心病患者。根据心肌核素显像和冠状动脉造影结果确定缺血心肌靶目标, 行CSWT治疗。疗程为3个月, 共治疗9次。疗效评价分别采用临床症状描述、加拿大心血管学会心绞痛(CCS)分级、6 min步行试验、纽约心功能心脏病学会心功能(NYHA)分级、西雅图心绞痛量表(SAQ)、硝酸甘油使用量、左心室舒张末期直径(LVEDD)和左心室射血分数(LVEF)等;心肌核素显像评价治疗前后心肌缺血改善情况;观察患者治疗过程中症状、心电监测、血压和氧饱和度变化、治疗后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T、丙氨酸氨基转移酶(ALT)、肌酐、脑钠肽和超敏C反应蛋白(HsCRP)的变化评价其安全性。结果 CCS分级、NYHA分级、6 min步行试验和硝酸甘油用量在治疗第4个月和1年与治疗前相比均有改善(P<0.05)。心绞痛稳定状态和疾病认识程度有明显改善, 较治疗前差异均有统计学意义(P<0.05)。共治疗21个节段, 治疗后静息状态心肌缺血的改善率为46.2%(6/13), 其中有效率为38.5%(5/13), 明显有效率为7.8%(1/13);负荷状态心肌缺血的改善率为57.1%(12/21), 其中有效率为47.6%(10/21), 明显有效率为9.5%(2/21)。与治疗前比较, CK、CK-MB、肌钙蛋白、ALT、肌酐、脑钠肽和HsCRP均无明显改变, 心率、收缩压、舒张压和氧饱和度亦无明显变化。结论 CSWT是一种安全、有效治疗老年冠心病患者的方法, 并能保持疗效至少1年。
引用
收藏
页码:736 / 740
页数:5
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