低强度红激光局部照射对冠状动脉成形术后再狭窄防治的初步临床探讨  

Primary clinical evaluation of intracoronary low power red laser illumination for prevention of restenosis following coronary angioplasty

作　　者：陈纪言[1] 李光[1] 周颖玲[1] 杨向太[1] 罗建方 谭宁[1] 李瑜辉[1] 陆骊工[1] 

机构地区：[1]广东省心血管病研究所,广州510080

出　　处：《中华心血管病杂志》2000年第4期282-284,共3页Chinese Journal of Cardiology

摘　　要：目的　探讨一定能量密度的低强度红激光对经皮冠脉成形术 (PTCA)后再狭窄的预防作用。方法　 5 5例PTCA的患者随机分成单纯PTCA组 (对照组 ) 2 9例和PTCA加冠脉内局部低强度红激光照射组 (治疗组 ) 2 6例 ,照射的能量密度为 0 9J/cm2 。随访终点为术后 6个月。结果　所有PTCA术后血流均达到TIMI 3级 ,残余狭窄在 30 %以下 ,无发生严重并发症。到随访终点 ,治疗组有 4例患者 ,对照组有 7例患者复发心绞痛 (P >0 0 5 ) ;39例患者术后半年进行冠状动脉造影复查 ,治疗组有 1例患者 ,对照组有 5例患者出现再狭窄 (P <0 0 5 ) ;两组之间冠脉内径下降幅度差异有显著性(P <0 0 5 )。另外 16例患者因无临床症状 ,活动平板试验阴性而未再进行冠脉造影。无 1例发生急性心肌梗死或需冠状动脉搭桥术。结论　低强度红激光局部照射对冠脉成形术后再狭窄有预防作用 ,确切的疗效有待于大规模临床试验明确。Objective To investigate the role of a certain density of low power red laser for prevention of restenosis following coronary angioplasty. Methods 55 patients were divided randomly into tow groups: PTCA group (control group) and PTCA plus intracoronary low power red laser illumination group (treatment group). The density of red laser illumination was 0 9 J/cm 2 All patients received clinical follow-up and some of the patients received repeated coronary angiography within 6 months. Results TIMI 3 flows were achieved in all cases and residual stenosis was less than 30%. No severe complications were found. At the end of 6 months follow-up, there was 4 cases in treatment group and 7 case in control group experienced recurrent angina respectively. 39 patients received repeated coronary angiography. Of which only one case in treatment group but five patients in control group expressed restenosis. There were significant differences in amplitude of decreasing in minimal lumen diameter between tow groups. The other 16 cases who didn′t received repeated coronary angiography remained symptom-free with negative treadmill exercise test. No major clinical events were found in all cases during follow up.Conclusion Low power red laser illumination can achieve low restenosis rate after percutaneous coronary intervention without complication. However, a large randomized study is necessary to further evaluate its clinical efficacy.

关 键 词：冠心病 低强度红激光局部照射 PTCA 狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]