体外心脏震波治疗冠心病患者的临床研究

摘要

目的 探讨体外心脏震波治疗系统(CSWT)治疗冠心病的安全性及疗效.方法 将45例冠心病患者随机分为震波治疗组(予CSWT治疗,n=25)及对照组(不予震波治疗,n=20).3个月为1个震波治疗周期,共行9次震波治疗.震波治疗组患者检测时间点为震波治疗前(0个月)、9次震波治疗结束时(3个月)、随访6个月时(6个月),对照组的相应检测时间点分别为入选时、随访3个月时、随访6个月时.两组患者分别在上述时间点行99Tcm-甲氧基异丁基异腈(99Tcm-MIBI)及18F-氟脱氧葡萄糖(18F-FDG)双核素单光子发射型计算机断层成像(SPECT)心肌显像检查及微伏级T波电交替(MTWA)检查,评估加拿大心血管学会(CCS)心绞痛分级、纽约心脏协会(NYHA)心功能分级、西雅图心绞痛量表(SAQ)评分、6 min步行距离(6MWT)、左心室射血分数(LVEF).临床随访不少于6个月,比较两组患者的病死率、心肌再梗死率、再住院率、心肌灌注、心肌代谢及心功能的变化.结果 45例患者均完成随访.震波治疗组患者在3个月、6个月时的心肌灌注及代谢、NYHA心功能分级、CCS心绞痛分级、硝酸甘油用量、SAQ评分、6MWT、LVEF、MTWA均比0个月时明显改善(P＜0.05),且上述指标均比同期对照组明显改善(P＜0.05).震波治疗组患者治疗后无死亡、无心肌再梗死发生.结论 CSWT是一项无创、安全、有效的新型血管再生疗法,可作为冠心病治疗的选择.%Objective To compare the characteristics of the 4th generation enzyme-linked immunosorbent assay (ELISA)[HIV (1 + 2) antibody combined with P24 antigen test] and colloidal selenium method in the clinical HIV testing. Methods The 4th generation ELISA reagent and colloidal selenium reagent were employed to test HIV antibody,respectively. The positive samples preliminarily screened were sent to Chongqing Center for Disease Control and Prevention for the confirmatory test of Western blot. Results The positive rates of the 4th generation ELISA, colloidal selenium method and Western blot for HIV testing were 0. 34% , 0. 29% and 0. 27% respectively. The 4th generation ELISA showed lower HIV-omission rated. 3%) and higher HIV-false-posi-tive rate (0. 03%) than those of colloidal selenium method which were 4. 9% and 0. 01% respectively. Conclusion Combination of the 4th generation ELISA and colloidal selenium method may improve the accuracy of HIV testing.