低强度激光鼻腔内照射对脑梗死患者脑血流灌注的影响

Effects of low power laser irradiation in nasal cavity on cerebral blood flow perfusion of patients with brain infarction

目的研究低强度半导体激光鼻腔内照射对脑梗死患者脑血流灌注和脑细胞功能的影响。方法将39例脑梗死患者分为血管内照射(ILIB)组18例与鼻腔内照射(LINC)组21例。ILIB组患者仰卧于检查床上固定头位,先做SPECT基础脑灌注显像,随即行半导体激光血管内照射,时间30min,治疗后再做SPECT脑灌注显像。LINC组同样先做SPECT基础脑灌注显像,随即行半导体激光鼻腔内照射,时间30min,治疗后再做SPECT脑灌注显像。采用脑血流功能变化率(BFCR%)数学模型对患者病灶区和镜像区进行定量分析。结果2组激光治疗30min后,SPECT显示其全脑血流灌注和脑细胞功能状态均有明显改善,以病灶区局部脑血流量和脑细胞功能改善更为显著。治疗后病灶区局部/全脑灌注比值较治疗前明显增高,差异有统计学意义(P<0.01);镜像区局部/全脑灌注比值较治疗前增高,但差异无统计学意义(P>0.05);病灶区BFCR%明显高于镜像区,差异有统计学意义(P<0.01)。2组治疗后组间病灶区局部/全脑灌注比值及BFCR%比较,差异均无统计学意义(P>0.05)。结论低强度激光鼻腔内照射能改善脑梗死患者局部病灶脑血流量,激活脑细胞功能,有着较为广泛的临床应用前景。

Objective To study the effects of low power laser irradiation in nasal cavity on cerebral blood flow and cerebral function in patients with brain infarction. Methods Thirty-nine patients with cerebral infarction were divided into a intravenous laser irradiation group and a laser irradiation in nasal cavity group. For the group of intravenous irradiation (ILIB group,18 cases), the patients lay on the bed with their heads fixed and were treated with intravenous laser irradiation for 30 min. Both before and after the therapy they received a SPECT cerebral perfusion imaging separately. For the group of laser irradiation in nasal cavity (LINC group,21 cases), the patients received laser irradiation in nasal cavity for 30 min and also SPECT cerebral perfusion imaging tests both before and after therapy. BFCR% model was used to quantify the blood flow of the focal and mirror regions. Results SPECT showed that there was significant improvement in perfusion of the entire brain and cerebral function in both ILIB and LINC groups after 30 minutes of treatment,each compared to those before treatment; the changes in the focal rCBF and cerebral function were much more obvious (P<0.001).The rCBF and cerebral function in the mirror regions was also increased but there was no significant difference (P>0.05). BFCR% in focal region was significantly higher than that in mirror region (P<0.001). Comparing the rCBF of the focal region after treatment,there was no significant difference between ILIB group and LINC group (P>0.05). Conclusion Low power laser irradiation in nasal cavity can improve the focal rCBF and cerebral function of the patients with brain infarction, which is similar to that of the ILIB.