Effect Of Enhanced External Counterpulsation Combined With The Remote Ischemic Preconditioning On Endothelial Function In Patients With Coronary Heart Disease

Objectives: To explore the impact of enhanced external couterpulsation combined with the remote ischemic preconditioning on endothelial function in patients with coronary heart disease.Methods: From March 2015 to December 2015,80 patients were randomly divided into four groups:EECP group(20 cases),RIPC group(20 cases),EECP+RIPC group(20 cases)and control group(20 cases).All patients received conventional drug therapy(such as long-acting nitrates,calcium channel blocks,beta-adrenergic blocking agents,aspirin and so on)for eighteen days.The EECP group was received enhanced external couterpulsation plus conventional drug teatment twice a day.Samilily,The RIPC group was added to remote ischemic preconditioning training by 5 cycles of 5 min of unilateral hindlimb ischemia and 5 min of reperfusion once aday for the same day.The EECP+RIPC group was accepted enhanced external couterpulsation twice a day and remote ischemic preconditioning training once a day for 18 days.The level of NO2-/NO3-?ET-1?IL-6 and TNF-a was detected at 0,18 days,respectively.Results:(1)The level of NO2-/NO3-in the RIPC group and EECP group and EECP+RIPC group was higher than the control group [(99.42±9.32)?(89.78±6.39)?(97.62±10.33)vs(97.62±10.33)umol/L,P<0.05].Compared with that in the EECP group,the level of NO2-/NO3-in EECP+RIPC group was no significant difference[(99.42±9.32)vs(97.62±10.33)umol/L,P>0.05],but was higher than that in RIPC group [(99.42±9.32)?(97.62±10.33)vs(89.78±6.39)umol/L,P<0.05];(2)The level of ET-1 in the RIPC group and EECP group and EECP+RIPC group was lower than the control group [(109.58±14.41)?(147.47±34.27)?(112.15±15.43)vs(175.63±34.93)ng/L,P<0.05].Compared with that in the EECP group,the level of ET-1 in EECP+ RIPC group was no significant difference[(109.58±14.41)vs(112.15±15.43)ng/L,P>0.05],but was lower than that in RIPC group[(109.58±14.41)?(112.15±15.43)vs(147.47±34.27)ng/L,P<0.05];(3)The level of IL-6 in the RIPC group and EECP group and EECP+RIPC group was lower than the control group [(12.05±1.78)?(15.11±2.64)?(13.04±1.34)vs(18.65±2.65)ng/L,P<0.05].Compared with that in the EECP group,the level of IL-6 in EECP+RIPC group was no significant difference[(12.05±1.78)vs(13.04±1.34)ng/L,P>0.05],but was lower than that in RIPC group[(12.05±1.78)?(13.04±1.34)vs(15.11±2.64)ng/L,P<0.05];(4)The level of TNF-a in the RIPC group and EECP group and EECP+RIPC group was lower than the control group [(316.97±24.25)?(361.85±52.38)?(322.83±44.43)vs(406.90±44.12)ng /L,P<0.05].Compared with that in the EECP group,the level of TNF-a in EECP+RIPC group was no significant difference[(316.97±24.25)vs(322.83± 44.43)ng/L,P>0.05],but was lower than that in RIPC group[(316.97±24.25)?(322.83±44.43)vs(361.85±52.38)ng/L,P<0.05];Conclusions: Both EECP and RIPC had impact on reducing inflammation and improving endothelial function in patiengts with CAD.Howerre,their combined protective effect was not better than EECP.