Chauhan A, Mullins P A, Thuraisingham S I, Taylor G, Petch M C, Schofield P M
Regional Cardiac Unit, Papworth Hospital, Papworth Everard, Cambrdige, England, UK.
Circulation. 1994 Feb;89(2):694-702. doi: 10.1161/01.cir.89.2.694.
Although neurostimulation has been shown to be of benefit in angina pectoris, the exact mechanism of its action is not clear. This study was performed to examine the effect of transcutaneous electrical nerve stimulation on coronary blood flow.
The effect of transcutaneous electrical nerve stimulation was studied in 34 syndrome X patients (group 1), 15 coronary artery disease patients (group 2), and 16 heart transplant patients (group 3). Coronary blood flow velocity (CBFV) in the left coronary system was measured at rest and after a 5-minute stimulation period with a Judkins Doppler. There was a significant increase in the resting CBFV in group 1 (from 6.8 +/- 4.1 to 10.5 +/- 5.7 cm/s, P < .001) and group 2 (from 6.8 +/- 4.1 to 10.5 +/- 5.7 cm/s, P < .001). However, there was no significant change in the resting CBFV in group 3. There were no significant changes in the coronary arterial diameters as a result of neurostimulation. There was a significant decrease in the epinephrine levels in group 1 (from 79.6 +/- 17.8 to 58.5 +/- 17.5 ng/L, P = .01) and group 2 (from 102.2 +/- 27.2 to 64.1 +/- 19.1 ng/L, P = .01).
Transcutaneous electrical nerve stimulation can increase resting coronary blood flow velocity. The findings suggest that the site of action is at the microcirculatory level and that the effects may be mediated by neural mechanisms.
尽管神经刺激已被证明对心绞痛有益，但其确切作用机制尚不清楚。本研究旨在探讨经皮电神经刺激对冠状动脉血流的影响。
对34例X综合征患者（第1组）、15例冠状动脉疾病患者（第2组）和16例心脏移植患者（第3组）进行经皮电神经刺激效果研究。使用Judkins多普勒在静息状态和5分钟刺激期后测量左冠状动脉系统的冠状动脉血流速度（CBFV）。第1组（从6.8±4.1至10.5±5.7 cm/s，P<.001）和第2组（从6.8±4.1至10.5±5.7 cm/s，P<.001）静息CBFV显著增加。然而，第3组静息CBFV无显著变化。神经刺激后冠状动脉直径无显著变化。第1组（从79.6±17.8至58.5±17.5 ng/L，P=.01）和第2组（从102.2±27.2至64.1±19.1 ng/L，P=.01）肾上腺素水平显著降低。
经皮电神经刺激可增加静息冠状动脉血流速度。研究结果表明作用部位在微循环水平，其作用可能由神经机制介导。
