不同照射剂量低强度激光血管内照射治疗对脑梗死患者相关分子标志物的影响

Effect of the Intravascular Low Level Laser Irradiation with Different Doses of Different Lasers on the Blood Biomarkers in Patients with Cerebral Infarction

目的 探讨激光波长、照射强度及疗程长短对低强度激光血管内照射 (ILLLI)疗法治疗脑梗死疗效的影响。方法 12 1例经、中型急性脑梗死病人随机分入A、B、C、D、E5组。A组为对照组 ,给予常规药物 (尼莫地平、肠溶阿司匹林 )治疗 ;B、C、D组在常规药物治疗的同时分别加用相同功率 (1 5mW)、不同波长 (依次为 6 32 8、6 5 0、5 32nm)的ILLLI;E组在常规药物治疗的同时加用功率 3mW、波长 6 32 8nm的ILLLI。ILLLI每天 1次 ,每次 6 0min ,共治疗 10次。每次照射总能量B、C、D组为 5 4J,E组为 10 8J。治疗前和治疗开始后第 4、6或 11天测定病人血浆血小板颗粒膜蛋白 140 (GMP 140 )、内皮素 1(ET 1)和血清铜 锌超氧化物歧化酶 (Cu ZnSOD)含量。结果 治疗 10次 ,照射总能量为 5 4J(每天照射强度为 1 72× 10 4 J/cm2 )时 ,6 32 .8、6 5 0、5 32nm三种波长ILLLI治疗后病人血浆GMP 140含量均下降 ,但与对照组比较差异无统计学意义 ;三种波长ILLLI均可降低血浆ET 含量 ,但三者比较差异无显著意义 ;三种波长ILLLI均可明显升高血清Cu ZnSOD含量 ,其中 5 32nmILLLI效果更显著 ,6 32 .8nmILLLI总能量为 10 8J时疗效优于照射总能量为 5 4J的疗效。每天照射能量为 5 4J时 ,治疗 10天 (总能量 5 4J)

Objective This study is to investigate the effect of intravascular low level laser irradiation (ILLLI) with different doses of different lasers on the blood biomarkers in patients with cerebral infarction. Methods 121 patients with acute cerebral infarction of mild or intemediate severity were divided into 5 groups, among which group A was treated with nimodipine and aspirin as control, while group B, C and D were provided with ILLLI of same power (1 5 mW) and different wavelength (632 8, 650, 532 nm) in addition to nimodipine and aspirin treatment. Group E was treated with nimodipine and aspirin as well as 632 8 nm ILLLI of 3 mW. The serum concentration of GMP 140, Cu ZnSOD, ET 1 were investigated before and after ILLLI by means of radioimmune assay.Results After irradiation with laser of 532, 632 8, and 650 nm while total irradiation energy was 54 J(daliy energy intencity 1 72×10 4 J/cm 2), the serum concentration of GMP 140 was found decreased in all the patients of each group but this decreasing is not significant enough compared with control group; The serum concentration of ET 1 was decreased but revealed no significant difference among the effects of ILLLI with different wavelength; The serum concentration of Cu ZnSOD was enhanced and the index increased significantly after irradiation with laser of 532 nm at the same energy dose. Irradiated with 632 8 nm ILLLI at the dose as much as two times of 54 J(daliy energy intencity 1 72×10 4 J/cm 2), the serum concentration of Cu ZnSOD may increase more significantly. Increasing the course of treatment from 5 days(total irradiation energy 27 J) to 10 days(total irradiation energy 54 J), the index may elevate more prominently at the dose of 1 72×10 4 J/cm 2/day. Conclusions It is suggested that the photobiological stimulating effects may depend on the wavelength of the laser. The effect of ILLLI may be increased by increasing the light dose and the course of treatment in certain range.