Ultrasound therapy for treatment of lower extremity intermittent claudication.
Ultrasound therapy for treatment of lower extremity intermittent claudication.
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超声疗法用于治疗下肢间歇性跛行
DOI：
10.1016/j.amjsurg.2021.02.017
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发表时间：
2021-06
影响因子：
3
通讯作者：
Kaul S
中科院分区：
文献类型：
--
作者：
Landry GJ;Louie D;Giraud D;Ammi AY;Kaul S
虽然超声（US）常被视为一种诊断工具，但它也有可能被用作一种治疗方式。超声对内皮细胞施加机械应力并诱导一氧化氮合酶，该酶调节一氧化氮（一种强效血管扩张剂）的分泌。在动物缺血模型中，超声已被证明可改善后肢、心肌和脑灌注。我们对患有间歇性跛行的人类受试者的下肢进行了超声治疗的初步试验。
招募了10名患有间歇性跛行的受试者（5名男性，5名女性，平均年龄69.7±10.3岁）。将双腿置于一个特别设计的装置中，在超声换能器和腿部之间有水界面。受试者接受频率为250 kHz的脉冲超声治疗，每次30分钟，每周3次，共6周。在治疗前后进行踝肱指数（ABI）、6分钟步行试验（6MW）、步行障碍问卷（WIQ）和简明健康状况调查问卷（SF36）评估。治疗前后的结果采用配对t检验进行比较。
基线时的6分钟步行距离为352±70米，一次治疗后为353±70米（p = 0.99），治疗结束时为372±71米（p = 0.015）。治疗6周后ABI有改善的趋势（0.53±0.17对比0.64±0.12，p = 0.083）。6周后，WIQ总分（2.00±1.48对比2.63±1.38，p = 0.0001）、WIQ（距离）（2.07±1.54对比2.73±1.42，p = 0.036）和WIQ（楼梯）（2.00±1.67对比2.62±1.24，p = 0.034）有显著改善，WIQ（速度）有改善趋势（1.89±1.26对比2.46±1.43，p = 0.069）。在SF - 36中，6周后在生理功能（44.0±41.6对比50.5±41.1，p = 0.009）和因生理问题导致的角色受限（35.0±48.3对比60.0±49.6，p = 0.006）方面有显著改善。
治疗性超声是一种潜在的间歇性跛行无创治疗方法。初步研究的患者在治疗6周后6MW和WIQ结果有显著改善，ABI有非显著改善。需要进一步研究以明确最佳治疗频率和持续时间。
While often thought of as a diagnostic tool, ultrasound (US) can also potentially be used as a therapeutic modality. US applies mechanical stress on endothelial cells and induces nitric oxide synthase, which regulates the secretion of nitric oxide, a potent vasodilator. In animal ischemic models, US has been shown to improve hindlimb, myocardial, and cerebral perfusion. We performed a pilot trial of US therapy in the lower extremities of human subjects with intermittent claudication. 10 subjects (5 male, 5 female, mean age 69.7±10.3) with intermittent claudication were recruited. Both legs were placed in a specially designed with a water interfacebetweenUS transducers and the legs. Subjects underwent pulsed US therapy at 250 kHz frequency for 30 minutes for three treatments a week for six weeks. Pre and post treatment ankle:brachial index (ABI), 6-minute walk (6MW), Walking Impairment Questionnaire (WIQ), and Short Form 36 (SF36) were performed. Pre and post-treatment results were compared with paired t test. Six minute walking at baseline was 352±70m, after one treatment session 353±70m (p=0.99), and at completion 372±71m (p=0.015). There was a trend toward improved ABI after 6 weeks of treatment (0.53±0.17 vs 0.64±0.12, p=0.083). After six weeks, significant improvements were noted in overall WIQ score (2.00±1.48 vs 2.63±1.38, p=0.0001), WIQ (distance) 2.07±1.54 vs 2.73±1.42 (p=0.036), and WIQ (stair) 2.00±1.67 vs 2.62±1.24, p=0.034, with a trend in WIQ (speed), 1.89±1.26 vs 2.46±1.43, p=0.069. In the SF-36, significant improvements were noted in the domains of physical functioning (44.0±41.6 vs 50.5±41.1, p=0.009) and role limitations – physical (35.0±48.3 vs 60.0±49.6, p=0.006) after six weeks. Therapeutic US is a potential noninvasive treatment for intermittent claudication. Pilot study patients noted significant improvements in 6MW and WIQ results after 6 weeks of treatment. A nonsignificant improvement in ABI was noted. Further research will be needed to clarify optimal treatment frequency and duration.
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影响因子：
5.9
作者：
Dawson, DL;Cutler, BS;Strandness, DE
通讯作者：
Strandness, DE
DOI：
10.1016/j.echo.2019.05.012
发表时间：
2019-09-01
影响因子：
6.5
作者：
Mott, Brian;Ammi, Azzdine Y.;Kaul, Sanjiv
通讯作者：
Kaul, Sanjiv
影响因子：
37.8
作者：
Suchkova, VN;Baggs, RB;Francis, CW
通讯作者：
Francis, CW
DOI：
10.1016/0735-1097(92)90032-i
发表时间：
1992-09-01
影响因子：
24
作者：
SIEGEL, RJ;GAINES, P;CUMBERLAND, DC
通讯作者：
CUMBERLAND, DC
DOI：
10.1152/ajpheart.00690.2014
发表时间：
2015-08-15
影响因子：
4.8
作者：
Davis, Catherine M.;Ammi, Azzdine Y.;Kaul, Sanjiv
通讯作者：
Kaul, Sanjiv