ChiCTR2600125614 版本V1.0 版本创建时间2026/05/28 17:18:32 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2600125614 

最近更新日期:

Date of Last Refreshed on:

2026-05-28 17:18:12 

注册时间:

Date of Registration:

2026-05-28 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

经皮耳迷走神经刺激预防体外循环下心脏手术后急性肾损伤

Public title:

Percutaneous Auricular Vagus Nerve Stimulation in Preventing Acute Kidney Injury Following Cardiac Surgery with Cardiopulmonary Bypass

注册题目简写:

English Acronym:

研究课题的正式科学名称:

“经皮耳迷走神经刺激”预防体外循环下心脏手术后急性肾损伤的临床疗效:一项随机对照、干预性研究

Scientific title:

Clinical Efficacy of Transcutaneous Auricular Vagus Nerve Stimulation in Preventing Acute Kidney Injury Following Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Controlled Interventional Study

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李暖 

研究负责人:

陈钢 

Applicant:

Nuan Li 

Study leader:

Gang Chen 

申请注册联系人电话:

Applicant telephone:

+86 571 86006642

研究负责人电话:

Study leader's
telephone:

+86 571 86006642

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

22518555@zju.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

chengang120@hotmail.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

浙江省杭州市庆春东路3号

研究负责人通讯地址:

浙江省杭州市庆春东路3号

Applicant address:

No. 3 Qingchun East Road, Hangzhou City, Zhejiang Province

Study leader's address:

No. 3 Qingchun East Road, Hangzhou City, Zhejiang Province

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

浙江大学医学院附属邵逸夫医院

Applicant's institution:

Sir Run Run Shaw Hospital, Zhejiang University School of Medicine

研究负责人所在单位:

浙江大学医学院附属邵逸夫医院

Affiliation of the Leader:

Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

邵逸夫医院伦审2026研第0279号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

浙江大学医学院附属邵逸夫医院医学伦理委员会

Name of the ethic committee:

Ethics Committee,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-24 00:00:00

伦理委员会联系人:

杨漾池

Contact Name of the ethic committee:

Yang Yangchi

伦理委员会联系地址:

浙江省杭州市庆春东路3号

Contact Address of the ethic committee:

No. 3 Qingchun East Road, Hangzhou City, Zhejiang Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 571 86006811

伦理委员会联系人邮箱:

Contact email of the ethic committee:

yyc261@foxmail.com

研究实施负责(组长)单位:

浙江大学医学院附属邵逸夫医院

Primary sponsor:

Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University

研究实施负责(组长)单位地址:

浙江省杭州市庆春东路3号

Primary sponsor's address:

No. 3 Qingchun East Road, Hangzhou City, Zhejiang Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

浙江省

市(区县):

Country:

China

Province:

Zhejiang

City:

单位(医院):

浙江大学医学院附属邵逸夫医院

具体地址:

浙江省杭州市庆春东路3号

Institution
hospital:

Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University

Address:

No. 3 Qingchun East Road, Hangzhou City, Zhejiang Province

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self financing

研究疾病:

急性肾损伤  

Target disease:

acute kidney injury

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本项目拟通过一项随机对照研究评估围术期实施经皮耳迷走神经刺激对降低择期体外循环心脏手术患者术后急性肾损伤发生率的效果。本研究假设:相较于假刺激,围术期应用ta-VNS可显著降低患者术后7天内AKI发生率。同时,本研究将深入探讨ta-VNS对AKI严重程度、相关肾功能指标及生物标志物的影响,进而验证其作为一种无创神经调控手段在围术期肾脏保护中的临床应用价值。  

Objectives of Study:

This project aims to evaluate the effect of perioperative percutaneous auricular vagus nerve stimulation on reducing the incidence of postoperative acute kidney injury in patients undergoing elective cardiopulmonary bypass cardiac surgery in a randomized controlled trial. We hypothesize that, compared with sham stimulation, perioperative ta-VNS can significantly reduce the incidence of AKI within 7 days after surgery. Meanwhile, this study will further investigate the impact of ta-VNS on the severity of AKI, related renal function markers and biomarkers, thereby verifying the clinical value of this non-invasive neuromodulation approach in perioperative renal protection.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1.年龄≥18周岁。
2.拟在全身麻醉下行择期CPB心脏手术。
3.血清肌酐基线计算eGFR ≥ 60mL/min/1.73 m2。
4.美国麻醉医师协会分级(American Society of Anesthesiologists,ASA)为I-III级。
5.美国纽约心脏病学会(New York Heart Association,NYHA)心功能分级为I-III级。
6.具备充分的理解和沟通能力,能够配合研究流程。
7.自愿参加本研究,并且签署知情同意书。若受试者因无行为能力等原因不能阅读和签署知情同意书的,则需由其监护人代理知情过程并签署知情同意书。若受试者无阅读知情同意书能力(如文盲受试者),则需由见证人见证知情过程并签署知情同意书。

Inclusion criteria

1. Age >= 18 years; 2. Scheduled to undergo elective cardiac surgery with cardiopulmonary bypass (CPB) under general anesthesia. 3. Baseline estimated glomerular filtration rate (eGFR) calculated from serum creatinine >= 60 mL/min/1.73 m2. 4. American Society of Anesthesiologists (ASA) physical status classification Grade I–III. 5. New York Heart Association (NYHA) cardiac functional classification Grade I–III. 6. Possess adequate comprehension and communication ability to comply with study procedures. 7. Voluntary participation in this study and provision of signed informed consent. If a participant is unable to read or sign the informed consent form due to lack of legal capacity or other reasons, a legal guardian shall provide informed consent on their behalf and sign the form. If a participant is unable to read the informed consent form (e.g., illiterate participants), an impartial witness shall witness the informed consent process and sign the form.

排除标准:

1.单肾或肾移植术后、术前已接受RRT或术前已存在AKI(KDIGO标准)。
2.存在ta-VNS实施禁忌,如双侧耳廓刺激区域存在活动性感染、皮炎、破损或严重银屑病等皮肤病,对硅胶、电极凝胶等刺激装置材料过敏,合并未控制的心律失常、症状性心动过缓、病态窦房结综合征、Ⅱ度及以上房室传导阻滞、已植入心脏起搏器或者除颤器、颈动脉窦高敏症,未控制的癫痫或活动性消化性溃疡等。
3.入组前1个月内接受过迷走神经刺激、耳部针灸或经皮电神经刺激治疗。
4.长期使用且术前无法安全暂停的、显著影响自主神经张力或肾脏血流的药物。
5.术前存在活动性全身感染或脓毒症(依据Sepsis-3标准)。
6.入组前3个月内发生过急性缺血性、出血性卒中或急性心肌梗死。
7.合并严重肝功能不全(Child-Pugh C级)、急性肝衰竭或其他严重疾病。
8.除老年人/文盲外的弱势群体,包括危重患者、精神疾患者、认知损伤者、孕妇等。
9.存在研究者认为受试者不适合参加本研究的其他情况。

Exclusion criteria:

1. Solitary kidney, history of kidney transplantation, preoperative renal replacement therapy (RRT), or preoperative acute kidney injury (AKI) defined by the KDIGO criteria. 2. Presence of contraindications to ta-VNS, including active infection, dermatitis, skin lesions, or severe psoriasis in the bilateral auricular stimulation areas; allergy to materials of stimulation devices such as silica gel or electrode gel; concomitant uncontrolled arrhythmia, symptomatic bradycardia, sick sinus syndrome, atrioventricular block of second degree or higher, implanted cardiac pacemaker or defibrillator, carotid sinus hypersensitivity, uncontrolled epilepsy, or active peptic ulcer. 3. Received vagus nerve stimulation, auricular acupuncture, or transcutaneous electrical nerve stimulation within 1 month before enrollment. 4. Long-term use of medications that significantly affect autonomic tone or renal blood flow and cannot be safely discontinued preoperatively. 5. Preoperative active systemic infection or sepsis (according to Sepsis-3 criteria). 6. Acute ischemic stroke, hemorrhagic stroke, or acute myocardial infarction within 3 months before enrollment. 7. Severe hepatic insufficiency (Child-Pugh Class C), acute liver failure, or other severe comorbidities. 8. Vulnerable populations other than elderly or illiterate participants, including critically ill patients, individuals with psychiatric disorders, cognitive impairment, pregnant women, etc. 9. Any other conditions deemed by the investigators to render the participant unsuitable for this study.

研究实施时间:

Study execute time:

From 2026-04-01 00:00:00 To 2027-07-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-04-27 00:00:00 To 2027-01-01 00:00:00

干预措施:

Interventions:

组别:

假刺激组

样本量:

76

Group:

Sham Group

Sample size:

干预措施:

假刺激

干预措施代码:

Intervention:

Sham Stimulation

Intervention code:

组别:

经皮耳迷走神经刺激组

样本量:

76

Group:

Percutaneous Auricular Vagus Stimulation Group

Sample size:

干预措施:

经皮耳迷走神经刺激

干预措施代码:

Intervention:

Percutaneous Auricular Vagus Stimulation

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

浙江省 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

浙江大学医学院附属邵逸夫医院 

单位级别:

三级甲等 

Institution
hospital:

Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

需要急性RRT的比例及其持续时间。

指标类型:

次要指标

Outcome:

Proportion of patients requiring acute renal replacement therapy (RRT) and its duration.

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

围术期并发症与死亡率

指标类型:

次要指标

Outcome:

Perioperative complications and mortality

Type:

Secondary indicator

测量时间点:

术后30天内

测量方法:

心血管并发症(如新发心房颤动等心律失常、急性心梗、术后心肌损伤以及低心排血量综合征等)、脑卒中、肺栓塞、肺部感染、深静脉血栓、手术部位深部感染及全因死亡的发生率。

Measure time point of outcome:

Within 30 days postoperatively

Measure method:

Incidence of cardiovascular complications (including new-onset atrial fibrillation and other arrhythmias, acute myocardial infarction, postoperative myocardial injury, low cardiac output syndrome, etc.), stroke, pulmonary embolism, pulmonary infection, deep vein thrombosis, deep surgical site infection, and all-cause mortality.

指标中文名:

术后30天的血清肌酐与eGFR

指标类型:

次要指标

Outcome:

Serum creatinine and eGFR at 30 days postoperatively

Type:

Secondary indicator

测量时间点:

术后第30天

测量方法:

Measure time point of outcome:

On postoperative day 30

Measure method:

指标中文名:

AKI严重程度

指标类型:

次要指标

Outcome:

AKI Severity

Type:

Secondary indicator

测量时间点:

术后7天内

测量方法:

Measure time point of outcome:

Within 7 days postoperatively

Measure method:

指标中文名:

AKI发生率

指标类型:

主要指标

Outcome:

Incidence of AKI

Type:

Primary indicator

测量时间点:

术后7天内

测量方法:

Measure time point of outcome:

Within 7 days postoperatively

Measure method:

指标中文名:

自主神经功能

指标类型:

次要指标

Outcome:

Autonomic nervous function

Type:

Secondary indicator

测量时间点:

术前、术后24h、48h、72h

测量方法:

采集5min心电图信号,使用Kubios HRV软件分析心率变异性。

Measure time point of outcome:

Preoperatively, and at 24h, 48h, and 72h postoperatively.

Measure method:

A 5-minute ECG signal will be recorded, and heart rate variability will be analyzed using Kubios HRV software.

指标中文名:

肾功能恢复

指标类型:

次要指标

Outcome:

Recovery of kidney function

Type:

Secondary indicator

测量时间点:

术后七天内

测量方法:

Measure time point of outcome:

within postoperative day 7

Measure method:

指标中文名:

生物标志物

指标类型:

次要指标

Outcome:

Biomarkers

Type:

Secondary indicator

测量时间点:

术前、术后7天每天

测量方法:

Measure time point of outcome:

Daily from preoperative to postoperative day 7

Measure method:

指标中文名:

住院时长、ICU时长以及因并发症再次入院率

指标类型:

次要指标

Outcome:

Length of hospital stay, length of ICU stay, and rate of readmission due to complications.

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

早期恢复质量

指标类型:

次要指标

Outcome:

Quality of recovery in the early postoperative period

Type:

Secondary indicator

测量时间点:

术后7天内每日

测量方法:

术后早期恢复质量从多维度进行系统评估。机械通气时间定义为术后首次成功拔除气管插管的时间;血管活性药物指数于术后7天内每日进行计算,分别记录其峰值与均值;谵妄发生率采用意识模糊评估单(CAM)或ICU病人意识模糊评估单(CAM-ICU)于术后每日进行评估(连续7天);早期认知功能采用简易精神状态检查量表(MMSE)于术前1天、术后第3天及术后第7天进行筛查;睡眠质量采用理查兹-坎贝尔睡眠量表(RCS

Measure time point of outcome:

Daily within 7 days postoperatively

Measure method:

The quality of early postoperative recovery will be systematically assessed using a multidimensional approach.Duration of mechanical ventilation is defined as the time to first successful extubation after surgery.The vasoactive-inotropic score will be calculated daily within 7 days postoperatively, with its peak value and mean value recorded separately.The incidence of delirium will be assessed daily postoperatively for 7 consecutive days using the Confusion Assessment Method (CAM) or Confusion

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后保存  

说明

Fate of sample:

Preservation after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 99 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

受试者按Cleveland Clinic评分预测的需透析的AKI风险(高风险:≥6分vs.中低风险:1-5分)分层后,由独立统计人员通过计算机生成区组随机序列(区组大小为2或者4),以1:1比例分配至ta-VNS组或假刺激组。

Randomization Procedure (please state who generates the random number sequence and by what method):

After stratifying participants based on their risk of AKI requiring dialysis as predicted by the Cleveland Clinic score (high risk: ≥6 points vs. low-to-moderate risk: 1–5 points), an independent statistician generated a computer-generated random block sequence (with block sizes of 2 or 4) to assign participants in a 1:1 ratio to the ta-VNS group or the sham stimulation group.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

双盲

Blinding:

Double blind

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

其他研究人员如果对这项研究的原始数据感兴趣,可以在研究结束且论文发表半年后联系通讯作者,寻求有限度地查看这些数据,以供学术研究目的。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Other researchers who are interested in the raw data from this study may contact the corresponding author six months after the study is completed and the paper is published to seek limited access to the data for academic research purposes.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

CRF

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-05-28 17:18:12