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重复桑拿治疗可改善慢性闭塞性冠状动脉相关缺血患者的心肌灌注。

Repeated sauna therapy improves myocardial perfusion in patients with chronically occluded coronary artery-related ischemia.

机构信息

The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.

出版信息

Int J Cardiol. 2013 Jul 15;167(1):237-43. doi: 10.1016/j.ijcard.2011.12.064. Epub 2012 Jan 13.

Abstract

BACKGROUND

Repeated low-temperature sauna (Waon) therapy relieves ischemic symptoms in patients with peripheral arterial disease. We investigated whether Waon therapy could improve myocardial perfusion in patients with ischemia related to chronic total occlusion (CTO) of coronary arteries.

METHODS

Twenty-four patients who had ischemia in the CTO-related area were examined. The severity of ischemia was quantified by thallium-201 myocardial perfusion scintigraphy with adenosine. The Waon group (n=16) was treated daily for three weeks with a 60 °C far infrared-ray dry sauna bath for 15 min and then kept in a bed covered with blankets for 30 min. The control group (n=8) underwent myocardial perfusion scintigraphy twice with a three-week interval.

RESULTS

In the control group, neither summed stress score (SSS) nor summed difference score (SDS) of myocardial scintigraphy changed. However, Waon therapy improved both SSS (16 ± 7 to 9 ± 6, p<0.01) and SDS (7 ± 4 to 3 ± 2, p<0.01), and the improvement was greater in patients with higher SSS and SDS scores at the baseline. Waon therapy extended treadmill exercise time (430 ± 185 to 511 ± 192s, p<0.01) and improved flow-mediated dilation of the brachial artery (4.1 ± 1.3 to 5.9 ± 1.8%, p<0.05), but tended to decrease the number of circulating CD34-positive bone marrow-derived cells.

CONCLUSIONS

Waon therapy improves CTO-related myocardial ischemia in association with improvement of vascular endothelial function. This therapy could be a complementary and alternative tool in patients with severe coronary lesions not suitable for coronary intervention.

摘要

背景

重复低温桑拿(Waon)疗法可缓解周围动脉疾病患者的缺血症状。我们研究了 Waon 疗法是否可以改善与冠状动脉慢性完全闭塞(CTO)相关的缺血患者的心肌灌注。

方法

检查了 24 例 CTO 相关区域存在缺血的患者。通过腺苷 201 铊心肌灌注闪烁显像术量化缺血的严重程度。Waon 组(n=16)每天接受 60°C 远红外线干桑拿浴治疗 15 分钟,然后用毯子覆盖的床休息 30 分钟,持续 3 周。对照组(n=8)在 3 周间隔内进行两次心肌灌注闪烁显像术。

结果

在对照组中,心肌闪烁显像术的总和应激评分(SSS)和总和差异评分(SDS)均未改变。然而,Waon 疗法改善了 SSS(16±7 至 9±6,p<0.01)和 SDS(7±4 至 3±2,p<0.01),并且基线时 SSS 和 SDS 评分较高的患者改善更大。Waon 疗法延长了跑步机运动时间(430±185 至 511±192s,p<0.01),并改善了肱动脉血流介导的扩张(4.1±1.3 至 5.9±1.8%,p<0.05),但倾向于减少循环 CD34 阳性骨髓源性细胞的数量。

结论

Waon 疗法改善了与血管内皮功能改善相关的 CTO 相关心肌缺血。对于不适合冠状动脉介入治疗的严重冠状动脉病变患者,这种治疗可能是一种补充和替代工具。

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