低强度电刺激耳屏迷走神经治疗心房颤动临床研究  

Clinical study of low-intensity electrical stimulation of ear vagus nerve on atrial fibrillation

作　　者：张洁 侯月梅 ZHANG Jie;HOU Yue-mei(Department of Geriatrics,Shanghai Fengxian District Central Hospital,Shanghai 201499,CHINA)

机构地区：[1]上海市奉贤区中心医院老年医学科

出　　处：《海南医学》2019年第23期3004-3006,共3页Hainan Medical Journal

基　　金：上海市奉贤区科学技术委员会科学技术发展项目(编号:奉科20151004)

摘　　要：目的探究低强度电刺激耳屏迷走神经治疗心房颤动(AF)的临床效果。方法将2015年5月至2017年5月期间上海市奉贤区中心医院接诊符合纳入标准的120例阵发性和持续性AF门诊患者按照随机数表法分为观察组和对照组各60例,观察组给予耳屏迷走神经刺激(VNS),对照组给予乙胺碘呋酮口服,分别用心电图、动态心电图和心脏超声观察刺激6个月后两组患者的心率、心率变异(HRV)和左心室射血分数(LVEF)的变化情况。结果观察组和对照组患者的静息心率[(79.50±10.45)次/min vs(90.14±14.38)次/min]、中等量活动心率[(100.50±18.90)次/min vs(120.80±25.85)次/min]、24 h平均心率[(89.05±8.55)次/min vs(100.20±10.56)次/min]及6 min步行实验最大心率[(105.50±20.45)次/min vs(125.80±26.80)次/min]比较,观察组明显低于对照组,差异均具有统计学意义(P<0.05);观察组和对照组患者的正常R-R间期标准差(SDNN)[(41.05±16.70)ms vs(50.56±20.45)ms]、相邻正常R-R间期差值均方根(rMSSD)[(19.30±7.50)ms vs(26.50±8.90)ms]、R-R间期差值大于50 ms的心搏占总心搏的百分比(PNNS50%)[(4.51±1.45)%vs(6.37±2.05)%]、低频(LF)[(243.60±50.55)KHz vs(300.90±57.89)KHz]及低频/高频(LF/HF)[(2.50±0.52)%vs(4.05±0.75)%]比较,观察组均明显低于对照组,观察组和对照组的高频(HF)[(98.70±30.45)KHz vs(75.50±25.55)KHz],左心室射血分数(LVEF)[(50.50±7.85)%vs(43.80±6.54)%]比较,观察组明显高于对照组,差异均具有统计学意义(P<0.05)。结论低强度电刺激耳屏迷走神经可明显改善AF患者的临床症状,为AF的治疗提供新的方法与思路。Objective To explore the clinical effect of low-intensity electrical stimulation of vagus nerve on atrial fibrillation(AF). Methods A total of 120 paroxysmal and persistent AF outpatients, who admitted to Shanghai Fengxian District Central Hospital from May 2015 to May 2017, were selected and divided into the observation group and control group according to random number table method, with 60 cases in each group. The observation group was given tragus vagus nerve stimulation(VNS), while the control group was given amiodarone orally. The changes of heart rate, heart rate variability(HRV), and left ventricular ejection fraction(LVEF) of the two groups after 6 months of stimulation were observed by electrocardiogram, dynamic electrocardiogram, and cardiac ultrasound, respectively.Results The resting heart rate, moderate activity heart rate, 24 h average heart rate, 6 min walk test maximum heart rate of the observation group were(79.50 ± 10.45) times/min,(100.50 ± 18.90) times/min,(89.05 ± 8.55) beats/min,(105.50 ± 20.45) beats/min, respectively, which were significantly lower than corresponding(90.14 ± 14.38) times/min,(120.80±25.85) times/min,(100.20±10.56) beats/min,(125.80±26.80) times/min of the control group(all P<0.05);the normal RR interval standard deviation(SDNN), adjacent normal RR interval difference root mean square(rMSSD), percentage of heart beat with R interval difference greater than 50 ms(PNNS50%), low frequency(LF), ration of LF/high frequency(HF) of the observation group were(41.05±16.70) ms,(19.30±7.50) ms,(4.51±1.45)%,(243.60±50.55) KHz,(2.50 ± 0.52)%, respectively, which were significantly lower than corresponding(50.56 ± 20.45) ms,(26.50 ± 8.90) ms,(6.37±2.05)%,(300.90±57.89) KHz,(4.05±0.75)% of the control group(all P<0.05);while the high frequency(HF) and ejection fraction(LVEF) of the observation group were(98.70±30.45) KHz and(50.50±7.85)%, which were significantly higher than(75.50±25.55) KHz and(43.80±6.54)% of the control group(P<0.05). Conclusion Low intensity ele

关 键 词：心房颤动 低强度电刺激 耳屏迷走神经 心率变异 左心室射血分数 

分 类 号：R541.75[医药卫生—心血管疾病]