低强度半导体激光鼻腔内照射治疗急性心肌梗死的疗效初探  

Preliminary study of efficacy of intra-nasal radiation with low-density semiconductor laser for acute myocacdial infarction

作　　者：金昉虹[1] 戴皓洁[2] 朱平[1] 李眉[2] 张新建[1] 张秀兰[1] 任玲[2] 

机构地区：[1]首都医科大学附属北京同仁医院激光科,100730 [2]首都医科大学附属北京同仁医院核医学科,100730

出　　处：《北京医学》2008年第1期16-19,共4页Beijing Medical Journal

摘　　要：目的探讨半导体激光鼻腔内照射改善心肌缺血及心功能状态的可行性及有效性。方法采用半导体激光鼻腔内照射治疗5例急性心肌梗死稳定期患者。于治疗前、后按常规分别进行单光子发生型计算机断层显像(SPECT)心肌灌注断层显像,观察心肌血流灌注图像,用定量法比较治疗前、后心功能参数的变化。结果治疗前患者室壁运动幅度、室壁增厚率和心肌灌注相对摄取值分别为(4.79±2.85)mm、(23.31±11.68)%、(57.92±18.43)%,激光治疗后上述指标均有较明显升高,分别为(5.32±2.95)mm、(26.54±13.03)%、(59.92±18.30)%)。左室射血分数(LVEF)由治疗前的(41.00±5.77)%提高至(45.00±6.73)%;舒张末期容积(EDV)由治疗前的(146.50±18.19)ml下降至(141.75±14.66)ml;收缩末期容积(ESV)由治疗前的(86.75±16.19)ml下降至(77.75±13.18)ml。5例患者激光治疗前、后心肌灌注区靶心图及心肌短轴、垂直长轴和水平长轴断层图像显示,治疗前灌注减低缺损区域经治疗后,均有明显好转。讨论用99mTc-MIBI行心肌断层显像观察半导体激光鼻腔内照射治疗心肌梗死,可客观地了解心肌灌注及心功能改善情况,并为临床治疗和评价疗效提供有利的参考数据。Objective To explore the effect of low-intensity semiconductor Laser Irradiation treatment on myocardial blood flow perfusion and cardiac function. Methods Five patients with acute myocardial infarction in the stable phase were treated by intranasal cavity semiconductor laser irradiation. The output wavelength was 650nm and output power was 5mW with the total exposure time of 40min. Before and after treatment, the myocardial blood flow perfusion was routinely observed by SPECT. The changes of the cardiac function parameters before and after treatment were also automatically analyzed in quality by the computer system. Results Before treatment, the ventricular thickness, the ventricular wall motion and myocardial perfusion in patients were （4.79±2.85）mm, （23.31±11.68）% and （57.92± 18.43）% respectively. The above parameters were significantly increased after laser treatment, which were （5.32±2.95）mm, （26.54±13.03）% （59.92±18.30）% respectively. The main target parameter of left ventricular ejection fraction （LVEF） was increased from （41.00±5.77）% before treatment to （45.00±6.73） after treatment. The end-systolic volume （ESV） was decreased from （146.50＋18.19）ml before treatment to （141.75±14.66）mi after treatment. The end-diastolic volume （EDV） was decreased from （86.75±16.19）ml before treatment to （77.75±13.18）ml after treatment. It had clearly showed that in all of 5 patients the region of poor myocardial blood flow perfusion was markedly improved after laser treatment in the myocardial perfusion map in the target area, the cardiac short axis, horizontal long axis and vertical long axis. Conclusions Ischemic heart disease can be treated by low-intensity semiconductor laser irradiation in the intranasal cavity. It can also be used to accurately observe the changes of cardiac functions, especially on myocardial blood flow perfusion before and after laser treatment. SPECT can provide useful reference data for prognosis evaluation.

关 键 词：急性心肌梗死 低强度半导体激光 单光子发射型计算机断层显像 

分 类 号：R542.22[医药卫生—心血管疾病]