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脑内导管激光光生物调节疗法治疗宾斯旺格病和血管性帕金森综合征:研究与临床经验

Intracerebral Transcatheter Laser Photobiomodulation Therapy in the Treatment of Binswanger's Disease and Vascular Parkinsonism: Research and Clinical Experience.

作者信息

Maksimovich Ivan V

机构信息

Clinic of Cardiovascular Diseases named after Most Holy John Tobolsky, Moscow, Russia.

出版信息

Photobiomodul Photomed Laser Surg. 2019 Oct;37(10):606-614. doi: 10.1089/photob.2019.4649. Epub 2019 Aug 7.

Abstract

This research is devoted to intracerebral transcatheter laser photobiomodulation therapy (PBMT) in the treatment of ischemic and neurodegenerative lesions of cerebral white matter in patients with Binswanger's disease (BD) and vascular parkinsonism (VP) in comparison with conservative treatment methods. Recent studies have shown PBMT high potential in the treatment of various cerebral lesions. Twenty-seven patients with BD, 58-81 years of age (mean age 78), 17 (62.96%) men, and 10 (27.04%) women. Of these, test group 1-14 (51.85%) patients-underwent intracerebral transcatheter laser PBMT, and control group 1-13 (48.15%) patients-had conservative treatment. Besides, 62 patients with VP, 52-80 years of age (mean age 77), 48 (77.42%) men, and 14 (22.58%) women. Of these, test group 2-37 (59.68%) patients-underwent intracerebral transcatheter laser PBMT, and control group 2-25 (40.32%) patients-had conservative treatment. Good and satisfactory clinical results were obtained in Test group 1 and Test group 2 patients in 49 (92.45%) cases, with a persistent decrease of dementia and motor impairment, and recovery of cognitive functions and daily life activity. Control group 1 and Control group 2 patients showed a satisfactory clinical result in 6 (15.79%) cases. Persistent positive dynamics was not observed. Intracerebral transcatheter laser PBMT is a pathogenetically justified, effective treatment for BD and VP; it restores cerebral collateral and capillary blood supply, improves microcirculation, restores cellular and tissue metabolism, stimulates neurogenesis, and causes regenerative processes in the brain.

摘要

本研究致力于探讨经导管脑内激光光生物调节疗法(PBMT)治疗宾斯旺格病(BD)和血管性帕金森综合征(VP)患者脑白质缺血性和神经退行性病变,并与保守治疗方法进行比较。最近的研究表明,PBMT在治疗各种脑部病变方面具有很高的潜力。27例BD患者,年龄58 - 81岁(平均年龄78岁),男性17例(62.96%),女性10例(27.04%)。其中,试验组1有14例(51.85%)患者接受了经导管脑内激光PBMT,对照组1有13例(48.15%)患者接受了保守治疗。此外,62例VP患者,年龄52 - 80岁(平均年龄77岁),男性48例(77.42%),女性14例(22.58%)。其中,试验组2有37例(59.68%)患者接受了经导管脑内激光PBMT,对照组2有25例(40.32%)患者接受了保守治疗。试验组1和试验组2的患者在49例(92.45%)中获得了良好和满意的临床结果,痴呆和运动障碍持续减轻,认知功能和日常生活活动得到恢复。对照组1和对照组2的患者在6例(15.79%)中显示出满意的临床结果。未观察到持续的积极变化。经导管脑内激光PBMT是一种病因学上合理、有效的BD和VP治疗方法;它可恢复脑侧支和毛细血管血液供应,改善微循环,恢复细胞和组织代谢,刺激神经发生,并在大脑中引发再生过程。

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