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目的 探讨低能量氦氖激光血管内照射 (ILIB)对急性脑梗塞的疗效及对血液流变学血脂和经颅多普勒 (TCD)的影响。方法 对 142例急性梗塞患者随机分ILIB治疗组 72例和对照组70例 ,比较两组治疗 2 0d前后的血液流变学、血脂指标的变化及疗效 ,对其中大脑中动脉梗塞区两组各 2 4例治疗前后的TCD中的大脑中动脉 (MCA)、大脑前动脉 (ACA)及大脑后动脉 (PCA)的平均血流速度 (Vm)进行了比较。结果 ILIB治疗组疗效明显优于对照组 ,两组治愈显效率分别为 39%和2 9 % ,总有效率为 96 %和 80 % (χ2 =4.5 6 9,P <0 .0 5 )。其血液流变学和血脂中总胆固醇 (CHO)、载脂蛋白B(APOB)指标 ,治疗前后对比及与对照组比较 ,差异均有显著性 (P <0 .0 5或 0 .0 1)。TCD检测显示大脑中动脉供血区梗塞 ,ILIB组治疗后的变化为MCA的Vm增加 ,ACA的Vm减慢 ,ILIB组治疗后的Vm基本接近同龄健康人组。结论 ILIB能显著提高急性脑梗塞患者疗效 ,能改善血液流变学 ,部分血脂及血液动力学指标。
Objective To investigate the therapeutic effect of low energy He-Ne laser intravascular irradiation (ILIB) on acute cerebral infarction and its effect on hemorrheological lipid and transcranial Doppler (TCD). Methods A total of 142 patients with acute infarction were randomly divided into two groups: 72 cases in ILIB group and 70 cases in control group. The changes of blood rheology and blood lipid index before and after 20 days of treatment were compared between two groups. The mean blood flow velocity (Vm) of 24 middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) in 24 TCD patients before and after treatment were compared. Results The efficacy of ILIB treatment group was significantly better than that of the control group. The effective rates of the two groups were 39% and 29% respectively, and the total effective rates were 96% and 80% (χ2 = 4.56 9, P <0.05). The blood rheology and total cholesterol (CHO) and apolipoprotein B (APOB) in blood lipids, before and after treatment and compared with the control group, the difference was significant (P <0.05 or 0.01) . TCD showed cerebral infarction in the middle cerebral artery. The changes of the ILIB group were Vm of MCA and Vm of ACA. The Vm of the ILIB group was almost the same as that of healthy people of the same age. Conclusion ILIB can significantly improve the efficacy of patients with acute cerebral infarction, can improve blood rheology, blood lipids and hemodynamic parameters.