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目的 观察脑梗塞患者血小板α -颗粒膜蛋白 (GMP - 140 )在低能量氦氖激光血管内照射 (ILIB)过程中的动态变化 ,探讨ILIB治疗脑梗塞的最适剂量、疗程。方法 34例脑梗塞患者在常规治疗的基础上进行ILIB(6 32 .8nm、3.0mW )治疗 ,6 0min ,每日 1次 ,连续 15次为 1疗程 ,照射前及每两次后采血行GMP - 140检测 ,并设常规治疗组和正常对照组。结果 在ILIB照射过程中 ,血小板GMP - 140、血浆GMP - 140的动态变化曲线呈“L”形 ,说明照射前期激光对血小板活化的抑制作用明显 ,1周左右达极限 ,后期出现耐受现象。接受ILIB治疗的患者GMP - 140下降显著高于常规治疗组 (P <0 .0 0 5 )。说明激光有抑制血小板活化的作用 ,疗效显著。结论 临床应用ILIB治疗脑梗塞必须依据氦氖激光作用的特征 ,建议采用“低能量 ,短疗程 ,间歇治疗”的方案。
Objective To observe the dynamic changes of platelet α - granule membrane protein (GMP - 140) in patients with cerebral infarction under low energy He - Ne laser intravascular irradiation (ILIB) and to explore the optimal dosage and course of ILIB for cerebral infarction. Methods Thirty-four patients with cerebral infarction were treated with ILIB (6 32 .8nm, 3.0mW) on the basis of routine therapy. The patients were treated with 60 courses of treatment for 15 times a day for 60 minutes. The GMPs - 140 test, and set conventional treatment group and normal control group. Results During the course of ILIB irradiation, the dynamic curve of platelet GMP - 140 and plasma GMP - 140 showed “L” shape, indicating that pre - irradiation laser had obvious inhibition on platelet activation, reached the limit of about 1 week, and later appeared the tolerance phenomenon. The decrease of GMP - 140 in patients receiving ILIB was significantly higher than that in the conventional treatment group (P <0.05). Description of laser inhibition of platelet activation, a significant effect. Conclusions The clinical application of ILIB in the treatment of cerebral infarction must be based on the characteristics of He-Ne laser. It is recommended to adopt the scheme of “low energy, short course and intermittent treatment”.