激光血管内照射治疗脑梗死单光子发射计算机断层的研究

目的用单光子发射计算机断层仪(SPECT)脑灌注显像研究低能量激光血管内照射(ILIB)治疗缺血性脑血管病对局部脑血流量(rCBF)和脑细胞功能的影响。方法35例脑梗死患者中17例在常规药物治疗基础上加用ILIB治疗，治疗前和治疗后进行SPECT检查，自身对照。用脑血流功能变化率(BFCR％)数学模型进行定量分析。另外18例观察ILIB即时效应。结果18例脑梗死患者ILIB治疗30minSPECT显示脑缺血病灶区域局部和全脑rCBF均有改善，17例脑梗死患者ILIB疗程结束后与治疗前比较全脑血流灌注和脑细胞功能活动都有明显改善，以病侧rCBF和脑细胞功能改善更为显著。治疗后病灶的rCBF和脑功能活动比治疗前明显增高，差异有非常显著性(t=8.7249，P＜0.0001)；病灶镜像健侧治疗前后差异无显著性(t=1.3043，P＞0.05)，病灶的BFCR％明显高于镜像健侧，差异有非常显著性(t=6.9127，P＜0.0001)。结论ILIB能改善脑梗死患者局部病灶脑血流量和激活脑细胞功能，为该疗法治疗缺血性脑血管病提供了新的依据。

SPECT study on cerebral infarction treated with low energy intravascular laser irradiation on blood

Objective To study the effect of regional cerebral blood flow (rCBF) and cerebral cell function of low energy intravascular laser irradiation on blood (ILIB) for cerebral ischemia with SPECT (single photon emission computer tomography).Methods 35 patients with cerebral infarction were divided into two parts:A. 17 cases,based on the pharmaceutic treatment,were received the ILIB therapy.B.Other 18 cases,their instant effect of ILIB was also observed.Before and after treatment,the SPECT was performed in these patients with self-contrast method.The focus and mirror region were quantified with BFCR% model.Results Firstly,of 18 cases,the rCBF of focus and whole brain was improved under the SPECT screen after 30min of treatment.Secondly,compared with the pre-treatment,the whole brain blood perfusion and cerebral cell function of A.17 cases were markedly improved,especially in the effects of affected side were more prominence.While the rCBF and cerebral function in focus were obviously higher than pre-treatment(t=8.724 9,P<0.000 1).The focus and mirror region of non-affected side had no significant difference between the pre- and post-ILIB(t=1.304 3,P>0.05),but BFCR% in locus was higher than the mirror region of non-affected side(t=6.912 7,P<0.000 1).Conclusion The study shows that the ILIB can improve rCBF and activate the function of cerebral cells for cerebral infarction.It also provides a new evidence for treating cerebral ischemia with ILIB.