低强度无创迷走神经刺激治疗冠状动脉慢血流患者的短期效果观察  

Observation of the Short-term Effect of Low-level Tragus Stimulation in the Treatment of Patients with Coronary Slow Flow

作　　者：郭衍楷 张鹏珂 黄兵[3] 孙理华[2] 幸世峰[2] 王红艳 古再努尔·艾尼瓦尔 闫慧[2] 曹桂秋[2] GUO Yankai;ZHANG Pengke;HUANG Bing;SUN Lihua;XING Shifeng;WANG Hongyan;Guzainuer·Aniwaer;YAN Hui;CAO Guiqiu(Department of Cardiology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Department of Cardiology,The Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心,乌鲁木齐830011 [2]新疆医科大学第五附属医院心内科,乌鲁木齐830011 [3]武汉大学人民医院心内科,武汉430060

出　　处：《岭南心血管病杂志》2023年第5期486-492,共7页South China Journal of Cardiovascular Diseases

基　　金：新疆维吾尔自治区区域协同创新专项(科技援疆计划)(项目编号:2020E0274)。

摘　　要：目的观察低强度无创迷走神经刺激(tragus stimulation,TS)对冠状动脉慢血流(coronary slow flow,CSF)患者的短期治疗效果。方法选取2020年1月至2021年12月就诊于新疆医科大学第五附属医院心血管内科,行冠状动脉造影(coronary angiography,CAG)检查诊断为CSF的患者共60例,并随机分配为实验组(TS组,n=30)和对照组(N-TS组,n=30),TS组给予无创迷走神经刺激30 min,N-TS组给予假刺激30 min,采用校正的心肌梗死溶栓治疗帧数计数(corrected TIMI frame count,CTFC)法计算刺激前后两组患者冠状动脉血流速度,记录其一般临床资料、生化指标以及术前、术后12导联心电图,同时分析干预前后心率变异性(heart rate variability,HRV)中频域成分低频功率(low frequency,LF)、高频功率(high frequency,HF)、LF/HF的变化。结果TS组及N-TS组患者在一般情况、生化指标、刺激前各冠状动脉CTFC值、刺激前HRV中LF、HF、LF/HF在基线水平比较,差异无统计学意义(P>0.05)。TS组患者左前降支(left anterior descending artery,LAD)、左回旋支(left circumflex artery,LCX)、右冠状动脉(right coronary artery,RCA)的CTFC值较刺激前均下降,差异有统计学意义(P<0.05),且刺激后TS组各支冠状动脉的CTFC值较N-TS组差异有统计学意义(P<0.05);TS组患者的LF/HF、LF水平较刺激前降低,HF水平较刺激前升高,差异有统计学意义(P<0.05)。结论低强度无创迷走神经刺激术可以改善CSF患者的冠状动脉血流速度。Objectives To observe the short-term effect of low-level tragus stimulation(TS)in the treatment of patiens with coronary slow flow(CSF).Methods From January 2020 to December 2021 in The Fifth Affiliated Hospital of Xinjiang Medical University,60 patients which were diagnosed with CSF by coronary angiography(CAG)were enrolled.And they were randomly divided into treatment group(TS group,n=30)and control group(N-TS group,n=30).TS group was treated with TS for 30 mins,while N-TS group was performed with shame stimulation for 30 mins.After 30 mins of TS or shame stimulation for two groups,the CAG was performed again to evaluate the coronary blood flow by corrected thrombolysis in myocardial infarction frame count(CTFC)method.The changes of the CTFC values before and after the stimulation were compared.The general clinical data,complicating diseases,some other biochemical indicators and the electrocardiograms during the angiography were recorded,and the changes of the parameters of the heart rate variability(HRV)which included low frequency(LF),high frequency(HF),LF/HF ratio were analyzed.Results After the stimulation,the CTFC values of the left anterior descending artery(LAD),the left circumflex artery(LCX)and the right coronary artery(RCA)in TS group were significantly decreased(P<0.05),and compared with N-TS groups,the CTFC value of each coronary artery in TS group was significantly lower(P<0.05).After the stimulation,the levels of LF and LF/HF in TS group were lower(P<0.05),while the level of HF was higher(P<0.05),and the changes of the parameters of the HRV in TS group were significantly different from those in N-TS group(P<0.05).Conclusions Low-level TS can improve coronary blood flow velocity in patients with CSF.

关 键 词：无创迷走神经刺激 冠状动脉慢血流 心率变异性 

分 类 号：R541.4[医药卫生—心血管疾病]