低强度半导体激光口咽部照射对急性缺血性脑血管病患者血液流变学及纤溶功能的影响

目的　研究无创性激光疗法对急性缺血性脑血管病(ICVD)患者血液流变学和纤溶功能的影响。方法　60例ICVD患者随机分为3组,每组20例,均予通脉液500ml、川芎嗪100mg静脉滴注,每天1次,共10天;其中2组分别另行低强度半导体激光口咽部照射(无创组)或HeNe激光血管内照射(ILLLI组),前者功率9mW,照射30min,后者功率15～20mW,照射60min,每天1次,共10天。观察3组患者治疗后血液流变学指标和纤溶功能的变化。结果　(1)血液流变学指标:治疗后无创组全血粘度高切、低切和血小板聚集率下降(P<001),血浆粘度和红细胞聚集率无明显变化;ILLLI组上述5项指标均下降(P<001);而药物治疗组仅血小板聚集率降低(P<001)。(2)纤溶功能指标:治疗后无创组纤维蛋白原(FBG)含量和纤溶酶原激活物抑制剂(PAI)活性降低(P<001),组织型纤溶酶原激活物(tPA)活性和纤维蛋白降解物(FDP)含量增高(前者P<005,后者P<001),D二聚集(DD)含量无明显变化;ILLLI组FBG、PAI、tPA、FDP的变化与无创组相似,同时DD含量增高(P<005);而药物组仅tPA活性增高(P<005)。结论　低强度激光口咽部照射也具有改变血液流变学指标和激活纤溶功能的作用,这一结果为口咽部低强度激光照射治疗急性ICVD提供了证据。

Effect of Nontraumatic Semiconducter Low Level Laser Oropharynx Irradiation on Hemorheologic and Hemofibrinolytic Function in Patients with Acute Ischemic Cerebrovascular Disease

Objective Thepresentstudyaimedatefficacyofnontraumaticsemiconducterlowlevellaseroropharynxirradiationonhemorheologicandhe mofibrinolyticfunctioninpatientswithacuteischemiccerebrovasculardisease(ICVD) . Metheds Sixtypatientswererandomlydividedintonontraumaticgroup( 2 0cases) ,ILLLIgroup( 2 0cases)andmedicationgroup( 2 0cases) . AllpatientsweregivenDextron 5 0 0mlandLigustraziniphosphatis 10 0mgintravenouslyperdayfor 10days.Atthesametime,ILLLIgroup wastreatedwithILLLI 60minperdayfor 10days,andnontraumaticgroupwastreatedwithsemiconducterlowlevellaseroropharynxirradi ation 3 0minperdayfor 10days.Hemorheologicandhemofibrinolyticfunctionsweredeterminedbeforeandafterthetreatment. Results ResultsshowedthatILLLIdecreasedthewholebloodviscosity ,plasmaviscosityandplateletaggregationrate (P <0 0 1) , reducedRBCaggregationindexandfibrinogenlevel (P <0 0 1) .Oropharynxirradiationdecreasedthewholebloodviscosityandplateletaggregationrate(P <0 0 1) ,reducedfibrinogenlevel(P <0 0 1) .Thedrugsdecreasedonlyplateletaggregationrate(P <0 0 1) .Afterthe treatmentILLLIincreasedt PAactivity (P <0 0 1) ,FDPandD Dlevel(P <0 0 5 ) ,decreasedPAIactivity(P <0 0 1)andFBGlevel(P < 0 0 1) .Oropharynxirradiationincreasedt PAactivity (P <0 0 5 )andFDPlevel (P <0 0 1) ,decreasedPAIactivity(P <0 0 1)andFBG level(P <0 0 1) .Thedrugincreasedonlyt PAactivity(P <0 0 5 ) . Conclusions OropharynxirradiationwasalsoeffectiveinimprovingthehemorheologicandfibrinolyticfunctionsinpatientswithacuteICVD , theresultprovidedanevidenceforlowlevellaseroropharynxirradiationbeingabletotreatacuteICVD .