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目的探讨半导体激光鼻腔内照射改善心肌缺血及心功能状态的可行性及有效性。方法采用半导体激光鼻腔内照射治疗5例急性心肌梗死稳定期患者。于治疗前、后按常规分别进行单光子发生型计算机断层显像(SPECT)心肌灌注断层显像,观察心肌血流灌注图像,用定量法比较治疗前、后心功能参数的变化。结果治疗前患者室壁运动幅度、室壁增厚率和心肌灌注相对摄取值分别为(4.79±2.85)mm、(23.31±11.68)%、(57.92±18.43)%,激光治疗后上述指标均有较明显升高,分别为(5.32±2.95)mm、(26.54±13.03)%、(59.92±18.30)%)。左室射血分数(LVEF)由治疗前的(41.00±5.77)%提高至(45.00±6.73)%;舒张末期容积(EDV)由治疗前的(146.50±18.19)ml下降至(141.75±14.66)ml;收缩末期容积(ESV)由治疗前的(86.75±16.19)ml下降至(77.75±13.18)ml。5例患者激光治疗前、后心肌灌注区靶心图及心肌短轴、垂直长轴和水平长轴断层图像显示,治疗前灌注减低缺损区域经治疗后,均有明显好转。讨论用99mTc-MIBI行心肌断层显像观察半导体激光鼻腔内照射治疗心肌梗死,可客观地了解心肌灌注及心功能改善情况,并为临床治疗和评价疗效提供有利的参考数据。
Objective To investigate the feasibility and effectiveness of semiconductor laser intranasal irradiation to improve myocardial ischemia and cardiac function. Methods Five patients with acute myocardial infarction were treated with semiconductor laser intranasal irradiation. Before and after treatment, single photon emission computed tomography (SPECT) myocardial perfusion imaging was performed routinely to observe myocardial perfusion imaging. The changes of cardiac function parameters before and after treatment were compared by quantitative method. Results Before treatment, the relative amplitude of ventricular wall motion, ventricular wall thickening and myocardial perfusion were (4.79 ± 2.85) mm, (23.31 ± 11.68)% and (57.92 ± 18.43)%, respectively (5.32 ± 2.95) mm, (26.54 ± 13.03)%, (59.92 ± 18.30)%, respectively). The left ventricular ejection fraction (LVEF) increased from (41.00 ± 5.77)% before treatment to (45.00 ± 6.73)% before treatment; the end diastolic volume (EDV) decreased from 146.50 ± 18.19 ml before treatment to 141.75 ± 14.66 ml; the end-systolic volume (ESV) decreased from (86.75 ± 16.19) ml to (77.75 ± 13.18) ml before treatment. 5 patients before and after laser treatment bull’s-eye bullheter bull’s-eye area and myocardial short axis, vertical long axis and horizontal long axis tomographic images showed that before treatment, perfusion to reduce the defect area after treatment, were significantly improved. Discussion Using 99mTc-MIBI myocardial slice tomography to observe the intra-laser irradiation of nasal cavity in the treatment of myocardial infarction can objectively understand the myocardial perfusion and cardiac function improvement, and provide favorable reference data for clinical treatment and evaluation of the curative effect.