摘要
目的:探讨低强度经耳迷走神经刺激(LL-TS)在非ST段抬高型心肌梗死(NSTEMI)患者经早期皮冠状动脉介入治疗(PCI)术中应用的安全性和有效性。方法:选取2017年1月至2018年6月我院确诊为NSTEMI行早期PCI患者78例,随机分为LL-TS组(37例)和对照组(41例),所有患者从进入导管室开始将正电极放置在患者右耳的耳屏处,LL-TS组对迷走神经进行间歇性刺激,对照组不刺激。观察并比较两组患者肌钙蛋白T(c Tn T)峰值、肌酸激酶同工酶(CK-MB)峰值,B型利钠肽(BNP),左心室射血分数(LVEF),肿瘤坏死因子α(TNF-α),白细胞介素6(IL-6)及心率变异性(HRV)时域指标、心律失常发生率。结果:LL-TS组术后c Tn T峰值、CK-MB峰值均明显低于对照组,LL-TS组术后HRV时域指标高于对照组,频发室早发生率与室速发生率均明显低于对照组,差异均有统计学意义(P<0.05)。LL-TS组术后1周LVEF高于对照组,但差异无统计学意义(P>0.05)。LL-TS组术后24 h及1周BNP均低于对照组,对照组术后24 h IL-6及TNF-α高于LL-TS组,差异均有统计学意义(P<0. 05)。结论:LL-TS能够减少NSTEMI患者PCI术中的心肌损伤,减少室性心律失常的发生,改善心功能,且未见不良事件的发生率增加,是安全有效的。
Objective To investigate the safety and efficacy of low-level transauricular vagal stimulation(LL-TS)in patients with non-ST-segment elevation myocardial infarction(NSTEMI)undergoing early percutaneous coronary intervention(PCI).Methods 78 patients with NSTEMI who underwent early PCI in our hospital from January 2017 to June 2018 were randomly divided into LL-TS group(37 cases)and control group(41 cases).All patients placed the positive electrode in the tragus of the patient’s right ear from the beginning of entering the catheter room.The vagus nerve was stimulated intermittently in LL-TS group.The control group was not stimulated.The peak values of troponin T(c Tn T),creatine kinase isoenzyme(CK-MB),B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),tumor necrosis factor alpha(TNF-α),interleukin-6(IL-6),heart rate variability(HRV)and the incidence of arrhythmia were observed and compared between the two groups.Results The peak values of c Tn T and CK-MB in the LL-TS group were significantly lower than those in the control group.The HRV time-domain index in LL-TS group were higher than those in control group.The incidence of frequent ventricular premature beats and ventricular tachycardia in LL-TS group were significantly lower than those in control group(P<0.05).LVEF in LL-TS group was higher than that in the control group at one week after operation,but the difference was not statistically significant(P>0.05).BNP in LL-TS group was lower than that in control group at 24 hours and 1 week after operation.IL-6 and TNF-a in control group were higher than those in LL-TS group at24 hours after operation(P<0.05).Conclusion LL-TS can reduce myocardial injury,reduce ventricular arrhythmia and improve cardiac function in patients with NSTEMI during PCI.It is safe and effective.
作者
张丹
操传斌
姚维
王能
张振建
ZHANG Dan;CAO Chuan-bin;YAO Wei;WANG Neng;ZHANG Zhen-jian(Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Suizhou Hospital,Hubei University of Medicine,Suizhou,Hubei 441300,China)
出处
《湖北医药学院学报》
CAS
2019年第3期264-268,共5页
Journal of Hubei University of Medicine
