增强型体外反搏治疗动脉粥样硬化性心血管疾病的研究进展

doi:10.12114/j.issn.1007-9572.2021.01.107

摘要/Abstract

摘要： 动脉粥样硬化性心血管疾病以慢性动脉粥样硬化为特征，可导致冠状动脉疾病、缺血性脑卒中、短暂性脑缺血发作及外周动脉疾病等，严重影响了人类健康。增强型体外反搏是一种安全、有效的无创性机械辅助循环方法，本综述将从危险因素、临床应用及机制几个方面探讨增强型体外反搏在动脉粥样硬化性心血管疾病防治方面的研究进展。

关键词: 动脉粥样硬化；增强型体外反搏；冠状动脉疾病；卒中；脑缺血发作, 短暂；外周动脉疾病；动脉粥样硬化性心血管疾病；综述

Abstract: Atherosclerotic cardiovascular disease is a systemic disease characterized by chronic atherosclerosis，which may result in coronary artery disease，ischemic stroke，transient ischemic attack and peripheral artery disease，seriously affecting human health. Enhanced external counterpulsation is a safe，noninvasive，and effective assisted circulation technique. We reviewed a series of recent advances in enhanced external counterpulsation for atherosclerotic cardiovascular disease，including reducing the risk of atherosclerotic cardiovascular disease，clinical use for refractory angina pectoris，ischemic cerebrovascular disease，and atherosclerosis of the lower extremity，and discussed relevant mechanisms of action.
Atherosclerosis；Enhanced external counterpulsation；Coronary artery disease；Stroke；Ischemic attack，transient；Peripheral arterial disease；Atherosclerotic cardiovascular disease；Review

蔡晓娜,何益平,翟小亚,等. 增强型体外反搏治疗动脉粥样硬化性心血管疾病的研究进展[J]. 中国全科医学, 2021, 24(35): 4535-4539. DOI: 10.12114/j.issn.1007-9572.2021.01.107.
CAI Xiaona,HE Yiping,ZHAI Xiaoya, et al. Recent Developments in Enhanced External Counterpulsation Therapy for Atherosclerotic Cardiovascular Disease　[J]. Chinese General Practice, 2021, 24(35): 4535-4539. DOI: 10.12114/j.issn.1007-9572.2021.01.107.

参考文献

［1］胡盛寿，高润霖，刘力生，等．《中国心血管病报告2018》概要［J］．中国循环杂志，2019，34（3）：209-220．DOI：10.3969/j.issn.1000-3614.2019.03.001.
HU S S，GAO R L，LIU L S，et al. Summary of the 2018 report on cardiovascular diseases in China［J］. Chin Circ J，2019，34（3）：209-220. DOI：10.3969/j.issn.1000-3614.2019.03.001.
［2］中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2019概要［J］. 中国循环杂志，2020，35（9）：833-854. DOI：10.3969/j.issn.1000-3614.2020.09.001.
The Writing Committee of the Report on Cardiovascular Health Diseases in China. Report on cardiovascular health and diseases in China 2019：an updated summary［J］. Chin Circ J，2020，35（9）：833-854. DOI：10.3969/j.issn.1000-3614.2020.09.001.
［3］BENJAMIN E J，VIRANI S S，CALLAWAY C W，et al. Heart disease and stroke statistics-2018 update：a report from the American heart association［J］. Circulation，2018，137（12）：e67-492. DOI：10.1161/CIR.0000000000000558.
［4］国际体外反搏学会，中国康复医学会心血管病专业委员会，中国老年学学会心脑血管病专业委员会. 心血管疾病康复处方——增强型体外反搏应用国际专家共识［J］. 中华内科学杂志，2014，53（7）：587-590. DOI：10.3760/cma.j.issn.0578-1426.2014.07.024.
［5］GUROVICH A N，BRAITH R W. Enhanced external counterpulsation creates acute blood flow patterns responsible for improved flow-mediated dilation in humans［J］. Hypertens Res，2013，36（4）：297-305. DOI：10.1038/hr.2012.169.
［6］LEONG D P，JOSEPH P G，MCKEE M，et al. Reducing the global burden of cardiovascular disease，part 2：prevention and treatment of cardiovascular disease［J］. Circ Res，2017，121（6）：695-710. DOI：10.1161/CIRCRESAHA.117.311849.
［7］RAY K K，SESHASAI S R，WIJESURIYA S，et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus：a meta-analysis of randomised controlled trials［J］. Lancet，2009，373（9677）：1765-1772. DOI：10.1016/s0140-6736（09）60697-8.
［8］CONTROL GROUP，TURNBULL F M，ABRAIRA C，et al. Intensive glucose control and macrovascular outcomes in type 2 diabetes［J］. Diabetologia，2009，52（11）：2288-2298. DOI：10.1007/s00125-009-1470-0.
［9］ROSS S，GERSTEIN H C，EIKELBOOM J，et al. Mendelian randomization analysis supports the causal role of dysglycaemia and diabetes in the risk of coronary artery disease［J］. Eur Heart J，2015，36（23）：1454-1462. DOI：10.1093/eurheartj/ehv083.
［10］HOLMAN R R，PAUL S K，BETHEL M A，et al. 10-year follow-up of intensive glucose control in type 2 diabetes［J］. N Engl J Med，2008，359（15）：1577-1589. DOI：10.1056/nejmoa0806470.
［11］GERSTEIN H C，MILLER M E，ISMAIL-BEIGI F，et al. Effects of intensive glycaemic control on ischaemic heart disease：analysis of data from the randomised，controlled ACCORD trial［J］. Lancet，2014，384（9958）：1936-1941. DOI：10.1016/s0140-6736（14）60611-5.
［12］KESKIN K，KILCI H，AKSAN G，et al. Serum oxidized low-density lipoprotein level as a marker of oxidative stress in patients undergoing hyperbaric oxygen therapy［J］. Turk Kardiyol Dern Ars，2017，45（6）：533-537. DOI：10.5543/tkda.2017.28302.
［13］AL-WAILI N S，BUTLER G J，BEALE J，et al. Influences of hyperbaric oxygen on blood pressure，heart rate and blood glucose levels in patients with diabetes mellitus and hypertension［J］. Arch Med Res，2006，37（8）：991-997. DOI：10.1016/j.arcmed.2006.05.009.
［14］BURESH R. Exercise and glucose control［J］. J Sports Med Phys Fit，2014，54（4）：373-382.
［15］LEY S H，HAMDY O，MOHAN V，et al. Prevention and management of type 2 diabetes：dietary components and nutritional strategies［J］. Lancet，2014，383（9933）：1999-2007. DOI：10.1016/s0140-6736（14）60613-9.
［16］SARDINA P D，MARTIN J S，DZIEZA W K，et al. Enhanced external counterpulsation（EECP）decreases advanced glycation end products and proinflammatory cytokines in patients with non-insulin-dependent type II diabetes mellitus for up to 6 months following treatment［J］. Acta Diabetol，2016，53（5）：753-760. DOI：10.1007/s00592-016-0869-6.
［17］SARDINA P D，MARTIN J S，AVERY J C，et al. Enhanced external counterpulsation（EECP）improves biomarkers of glycemic control in patients with non-insulin-dependent typeⅡ diabetes mellitus for up to 3 months following treatment［J］. Acta Diabetol，2016，53（5）：745-752. DOI：10.1007/s00592-016-0866-9.
［18］SAHEBJAMI F，MADANI F R，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.
［19］LEON M B，SMITH C R，MACK M J，et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients［J］. N Engl J Med，2016，374（17）：1609-1620. DOI：10.1056/nejmoa1514616.
［20］ETTEHAD D，EMDIN C A，KIRAN A，et al. Blood pressure lowering for prevention of cardiovascular disease and death：a systematic review and meta-analysis［J］. Lancet，2016，387（10022）：957-967. DOI：10.1016/S0140-6736（15）01225-8.
［21］LEONG D P，JOSEPH P G，MCKEE M，et al. Reducing the global burden of cardiovascular disease，part 2：prevention and treatment of cardiovascular disease［J］. Circ Res，2017，121（6）：695-710. DOI：10.1161/CIRCRESAHA.117.311849.
［22］CAMPBELL A R，SATRAN D，ZENOVICH A G，et al. Enhanced external counterpulsation improves systolic blood pressure in patients with refractory angina［J］. Am Heart J，2008，156（6）：1217-1222. DOI：10.1016/j.ahj.2008.07.024.
［23］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.
［24］MAY O，KHAIR W A. Enhanced external counterpulsation has no lasting effect on ambulatory blood pressure［J］. Clin Cardiol，2013，36（1）：21-24. DOI：10.1002/clc.22045.
［25］BECK D T，CASEY D P，MARTIN J S，et al. Enhanced external counterpulsation reduces indices of central blood pressure and myocardial oxygen demand in patients with left ventricular dysfunction［J］. Clin Exp Pharmacol Physiol，2015，42（4）：315-320. DOI：10.1111/1440-1681.12367.
［26］SARDINA P D，MARTIN J S，DZIEZA W K，et al. Enhanced external counterpulsation（EECP）decreases advanced glycation end products and proinflammatory cytokines in patients with non-insulin-dependent type II diabetes mellitus for up to 6 months following treatment［J］. Acta Diabetol，2016，53（5）：753-760. DOI：10.1007/s00592-016-0869-6.
［27］CASEY D P，BECK D T，NICHOLS W W，et al. Effects of enhanced external counterpulsation on arterial stiffness and myocardial oxygen demand in patients with chronic angina pectoris［J］. Am J Cardiol，2011，107（10）：1466-1472. DOI：10.1016/j.amjcard.2011.01.021.
［28］ZHANG C M，LIU X J，WANG X M，et al. Efficacy of enhanced external counterpulsation in patients with chronic refractory angina on Canadian cardiovascular society（CCS）angina class：an updated meta-analysis［J］. Medicine，2015，94（47）：e2002. DOI：10.1097/MD.0000000000002002.
［29］ABDELWAHAB A A，ELSAIED A M. Can enhanced external counter pulsation as a non-invasive modality be useful in patients with ischemic cardiomyopathy after coronary artery bypass grafting?［J］. Egypt Heart J，2018，70（2）：119-123. DOI：10.1016/j.ehj.2018.01.002.
［30］MARTIN J S，BECK D T，ARANDA J M，et al. Enhanced external counterpulsation improves peripheral artery function and glucose tolerance in subjects with abnormal glucose tolerance［J］. J Appl Physiol（1985），2012，112（5）：868-876. DOI：10.1152/japplphysiol.01336.2011.
［31］XU L，CHEN X，CUI M，et al. The improvement of the shear stress and oscillatory shear index of coronary arteries during Enhanced External Counterpulsation in patients with coronary heart disease［J］. PLoS One，2020，15（3）：e0230144. DOI：10.1371/journal.pone.0230144.
［32］LAWSON W E，HUI J C，KENNARD E D，et al. Enhanced external counterpulsation is cost-effective in reducing hospital costs in refractory angina patients［J］. Clin Cardiol，2015，38（6）：344-349. DOI：10.1002/clc.22395.
［33］MAY O，S?GAARD H J. Enhanced external counterpulsation is an effective treatment for depression in patients with refractory angina pectoris［J］. Prim Care Companion CNS Disord，2015，17（4）：10.4088/PCC.14m01748. DOI：10.4088/pcc.14m01748.
［34］QIN X X，DENG Y Y，WU D D，et al. Does enhanced external counterpulsation（EECP）significantly affect myocardial perfusion?：A systematic review & meta-analysis［J］. PLoS One，2016，11（4）：e0151822. DOI：10.1371/journal.pone.0151822.
［35］LIN S，XIAO-MING W，GUI-FU W. Expert consensus on the clinical application of enhanced external counterpulsation in elderly people（2019）［J］. Aging Med（Milton），2020，3（1）：16-24. DOI：10.1002/agm2.12097.
［36］XIONG L，LIN W H，HAN J H，et al. Enhancing cerebral perfusion with external counterpulsation after ischaemic stroke：how long does it last？［J］. J Neurol Neurosurg Psychiatry，2016，87（5）：531-536. DOI：10.1136/jnnp-2014-309842.
［37］LIN W，XIONG L，HAN J，et al. Increasing pressure of external counterpulsation augments blood pressure but not cerebral blood flow velocity in ischemic stroke［J］. J Clin Neurosci，2014，21（7）：1148-1152. DOI：10.1016/j.jocn.2013.09.023.
［38］LIN W，XIONG L，HAN J，et al. External counterpulsation augments blood pressure and cerebral flow velocities in ischemic stroke patients with cerebral intracranial large artery occlusive disease［J］. Stroke，2012，43（11）：3007-3011. DOI：10.1161/strokeaha.112.659144.
［39］XIONG L，TIAN G，WANG L，et al. External counterpulsation increases beat-to-beat heart rate variability in patients with ischemic stroke［J］. J Stroke Cerebrovasc Dis，2017，26（7）：1487-1492. DOI：10.1016/j.jstrokecerebrovasdis.2017.03.007.
［40］TIAN G，XIONG L，LIN W，et al. External counterpulsation reduces beat-to-beat blood pressure variability when augmenting blood pressure and cerebral blood flow in ischemic stroke［J］. J Clin Neurol，2016，12（3）：308-315. DOI：10.3988/jcn.2016.12.3.308.
［41］RAZUMOV A N，éNEEVA M A，KOSTENKO E V，et al. The depressive disorders during the early rehabilitation period following preceding ischemic stroke：the possibilities for the application of the enhanced external counterpulsation method［J］. Vopr Kurortol Fizioter Lech Fiz Kult，2016，93（1）：4-10. DOI：10.17116/kurort201614-10.
［42］ABOYANS V，SEVESTRE M A，DéSORMAIS I，et al. Epidemiology of lower extremity artery disease［J］. Presse Med，2018，47（1）：38-46. DOI：10.1016/j.lpm.2018.01.012.
［43］苏苗苗，陈忠. 股腘动脉粥样硬化性闭塞症的腔内治疗进展［J］. 心肺血管病杂志，2015，34（2）：150-153. DOI：10.3969/j.issn.1007-5062.2015.02.020.
［44］BADTIEVA V A，VOROSHILOVA D N，SICHINAVA N V. Use of enhanced external counterpulsation in the treatment and rehabilitation of patients with atherosclerosis obliterans of the lower extremity［J］. Vopr Kurortol Fizioter Lech Fiz Kult，2019，96（4）：5-11. DOI：10.17116/kurort2019960415.
［45］BUSCHMANN E E，BRIX M，LI L，et al. Adaptation of external counterpulsation based on individual shear rate therapy improves endothelial function and claudication distance in peripheral artery disease［J］. Vasa，2016，45（4）：317-324. DOI：10.1024/0301-1526/a000544.
［46］ZHU W，LIAO R，CHEN Y，et al. Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic anterior ischaemic optic neuropathy［J］. Graefes Arch Clin Exp Ophthalmol，2015，253（1）：127-133. DOI：10.1007/s00417-014-2823-z.