Abstract:Objective: To explore the efficacy of external counter-pulsation (ECP) combined with nicorandil on coronary microcirculation disorders and its effects on vascular endothelial function.Methods: From April 2017 to March 2019,240 patients with coronary microcirculation disorders and angina pectoris in our hospital were selected as the research objects,and they were divided into conventional treatment group (control group),ECP treatment group (ECP group),nicorandil treatment group (nicorandil group) and ECP combined with nicorandil treatment group (combined group) according to the simple random grouping method,with 60 cases in each group.The clinical efficacy of angina pectoris and clinical efficacy of electrocardiogram were recorded among the four groups after 6 months of treatment,and the positive rate of treadmill exercise test,incidence rate of abnormal wall motion,6-minute walking distance (6MWT),myocardial contrast echocardiography indexes and cardiopulmonary function were compared among the four groups before treatment and after 6 months of treatment.Results: There were no statistically significant differences in the clinical efficacy of angina pectoris and clinical efficacy of electrocardiogram between nicorandil group and ECP group (P>0.05).The clinical efficacy of angina pectoris and clinical efficacy of electrocardiogram in combined group were significantly higher than those in nicorandil group,ECP group and control group (P<0.05),and the clinical efficacy of angina pectoris and clinical efficacy of electrocardiogram in nicorandil group and ECP group were higher than those in control group (P<0.05).6 months after treatment,the positive rate of treadmill exercise test and the incidence rate of abnormal wall motion in the four groups were lower than those before treatment (P<0.05),and the two indexes in combined group were lower than those in nicorandil group,ECP group and control group (P<0.05),and the two indexes in nicorandil group and ECP group were lower than those in control group (P<0.05).The 6MWT and A value,β value and MBF in the four groups were higher than those before treatment (P<0.05),and the increases in combined group were greater than those in nicorandil group,ECP group and control group (P<0.05).And the increases in nicorandil group and ECP group were greater than those in control group (P<0.05).There were no significant differences in the PVO2,AT and PW in control group before and after treatment (P>0.05).6 months after treatment,the PVO2,AT and PW in combined group,nicorandil group and ECP group were higher than those before treatment (P<0.05),and the increases in combined group were greater than those in nicorandil group,ECP group and control group (P<0.05),and the increases in nicorandil group and ECP group were greater than those in control group (P<0.05).Conclusion: The combination of nicorandil and ECP has a significant effect in the treatment of coronary microcirculation disorders with angina pectoris.It improves the endothelial function and microcirculation perfusion of patients,and has high clinical application value.
叶伟云, 王晓霞, 陈小林, 高伶娇, 文达辉. 体外反搏联合尼可地尔治疗冠脉微循环障碍疗效及对血管内皮功能的影响[J]. 河北医学, 2020, 26(11): 1900-1906.
YE Weiyun, WANG Xiaoxia, CHEN Xiaolin, et al. Efficacy of External Counter-Pulsation Combined with Nicorandil on Coronary Microcirculation Disorders and Its Effectson Vascular Endothelial Function. HeBei Med, 2020, 26(11): 1900-1906.