体外反搏对代谢综合征患者血管内皮功能的影响

目的探讨体外反搏对代谢综合征(MS)患者血管内皮功能及胰岛素抵抗的影响及其作用机制。方法MS患者50例随机分为两组,增强型体外反搏(EECP)组20例,对照组30例。两组均进行健康教育,血压不低于150/95mmHg的患者给予贝那普利治疗,在此基础上,EECP组给予1h/d,共36h的体外反搏治疗。两组治疗前后测定血压、空腹血糖、血脂、胰岛素、胰岛素敏感指数(ISI)及肱动脉血管内皮依赖性舒张功能。结果两组治疗后内皮依赖性舒张功能均有改善(P<0.01),但EECP组改善更明显(Z=-3.743,P<0.01);EECP组患者治疗后空腹血糖、血清胰岛素水平明显下降(P<0.01),ISI明显升高(P<0.01),血脂代谢紊乱改善,甘油三酯降低(P<0.01),高密度脂蛋白胆固醇升高(P<0.05)。结论体外反搏通过提高血流切应力,可明显改善MS患者血管内皮依赖性舒张功能,改善胰岛素抵抗,为体外反搏的临床应用提供进一步的理论依据。

The effects of enhanced external counterpulsation on vascular endothelial function in patients with metabolic syndrome

Objective To investigate the effets of enhanced external counterpulsation(EECP)on endothelial function and insulin resistance in patients with metabolic syndrome(MS).Methods Fifty patients with MS were divided into 2 groups:30 patients in control group and 20 patients in EECP treatment group.All patients with MS were given healthy education.Some patients whose blood pressure(BP)was no lower than 150/95 mm Hg were administered Benazepril every day.Patients in EECP treatment group underwent a standard course of EECP(1 hour daily for 36 hours).BP,total cholesterol(TG),high density lipoprotein-cholesterol(HDL-C),fasting blood glucose(FBG),fasting insulin(FINS)and insulin sensitivity index(ISI)were measured before and after treatment.Results Compared with control group,endothelium-dependent vasodilation was significantly improved in EECP treatment group(P<0.05).BP,TG,FBG and FINS were significantly reduced after EECP treatment(P<0.01),while HDL-C and ISI significantly improved(P<0.05).Conclusion EECP treatment can significantly improve endothelium-dependent vasodilation in patients with MS by increasing the flow shear stress,reducing insulin resistance and provide experimental evidence for the clinical application of EECP.