低强度脉冲式超声波治疗老年冠心病心绞痛患者的疗效及对心率变异性的影响  

Efficacy of low-intensity pulsed ultrasound therapy on heart rate variability in elderly patients with coronary heart disease

作　　者：陈畅 张金鹏 彭洁[1] 曹爱红[1] 陈晓明[1] 张晨 沈琳[1] Chen Chang;Zhang Jinpeng;Peng Jie;Cao Aihong;Chen Xiaoming;Zhang Chen;Shen Lin(Department of Geriatric Medicine,Qilu Hospital of Shandong University,Shandong Provincial Key Laboratory of Cardiovascular Proteomics,Jinan 250012,Shandong China;Weifang Medical University,Weifang 250355,Shandong China)

机构地区：[1]山东大学齐鲁医院老年医学科,山东省心血管疾病蛋白质组学重点实验室,山东济南250012 [2]潍坊医学院,山东潍坊250355

出　　处：《中国医学前沿杂志（电子版）》2023年第4期44-49,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家自然科学基金(81800761)。

摘　　要：目的 探讨低强度脉冲式超声波(low intensity pulsed ultrasound,LIPUS)在老年冠心病心绞痛患者的应用效果及心率变异性(heart rate variability,HRV)的影响。方法 选取2021年11月至2022年9月山东大学齐鲁医院收治的老年冠心病心绞痛患者80例,应用SAS 9.4生成随机数字表法将80例患者分为超声组40例和对照组40例,两组患者均给予常规药物治疗,治疗组在此基础上辅以LIPUS治疗共计20次。比较治疗前后疗效、HRV指标及焦虑、抑郁、睡眠状态。结果 超声组和对照组患者基线临床资料比较,差异无统计学意义(P均>0.05)。超声组治疗前后比较,躯体活动受限程度、心绞痛稳定状态、心绞痛发作频率、治疗满意程度以及对疾病的认知程度5个维度及总分均提高,且提高水平显著优于对照组(P<0.05);对照组治疗前后比较心绞痛稳定状态得分以及总分提高,差异有统计学意义(P<0.05),躯体活动受限程度、心绞痛发作频率、治疗满意程度以及对疾病的认知程度差异无统计学意义(P>0.05)。超声组治疗后全部窦性心搏RR间期标准差(standard deviation of normal-to-normal intervals,SDNN)、相邻NN间期差值的均方根(root mean square of successive differences of NN intervals for period of interest,r MSSD)、相邻NN间期差异≥50ms的心搏百分数(percentage of adjacent NN intervals that differ from each other by larger than 50ms,PNN50)、低频功率(low frequency power,LF)和高频功率(high frequency power,HF)水平均升高,前述变化均显著优于对照组,对照组治疗后PNN50及HF均较前升高,以上指标差异均有统计学意义(P<0.05);对照组治疗后SDNN、相邻NN间期差值的均方根(root mean square of successive differences of NN intervals for period of interest,r MSSD)和LF较治疗前差异无统计学意义(P>0.05)。超声组治疗后汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、抑郁自评量表(Self-Rating Depression Scale,SDS)、匹兹堡睡�Objective To investigate the effect of low intensity pulsed ultrasound(LIPUS)on heart rate variability(HRV)in elderly patients with angina pectoris.Methods A total of 80 elderly patients with angina pectoris with coronary heart disease admitted to Qilu Hospital of Shandong University from November 2021 to September 2022 were selected and divided into ultrasound group(40 cases)and control group(40 cases)by using SAS 9.4 generation random number table method.There were 40 cases in the LIPUS group and 40 cases in the control group.Patients in both groups received conventional therapy.LIPUS treatment was conducted in LIPUS group with a total of 20 times.The efficacy,HRV indexes,anxiety,depression and sleep status were compared before and after treatment.Results There was no significant difference in baseline clinical data between two groups(all P>0.05).In the ultrasound group before and after treatment,the degree of physical activity restriction,stable state of angina pectoris,frequency of angina pectoris attack,satisfaction degree of treatment and cognition degree of disease were improved,and the improvement level was significantly better than that of the control group(P<0.05).For the control group,the score of angina pectoris stability and the total score significantly increased after treatment compared with before treatment(P<0.05).The score of physical activity limitation,the frequency of angina pectoris,the degree of treatment satisfaction and the degree of cognition of the disease did not show significant difference(P>0.05).Standard deviation of normal-to-normal intervals(SDNN),root mean square of successive differences of NN intervals for period of interest(rMSSD),percentage of adjacent NN intervals that differ from each other by larger than 50 ms(PNN50),low frequency power(LF)and high frequency power(HF)in the LIPUS group significant increased after treatment in LIPUS group.The changes of above parameters in LIPUS group were significantly higher than those in the control group(P<0.05).PNN50 and HF significant

关 键 词：低强度脉冲式超声波 心率变异性 心绞痛 

分 类 号：R541.4[医药卫生—心血管疾病]