Abela G S, Crea F, Smith W, Pepine C J, Conti C R
J Am Coll Cardiol. 1985 Feb;5(2 Pt 1):231-7. doi: 10.1016/s0735-1097(85)80042-5.
Use of the argon laser to recanalize stenosed arteries may require delivery of the beam through blood. To assess the degree of hemolysis and debris formation, 84 samples of citrated whole blood were exposed to argon laser radiation with varying power (1, 2 and 3 watts) and duration (5, 10, 20 and 40 seconds). Compared with control samples, only blood samples exposed to a power of 3 watts for 40 seconds showed a marked decrease in hematocrit (from 37 +/- 1.3 to 33 +/- 1.4%, p less than 0.01) and a marked increase in both free hemoglobin concentration (from 0.2 +/- 0.2 to 1.3 +/- 0.5 g/100 ml, p less than 0.01) and debris weight (from 0.9 +/- 0.3 to 2.8 +/- 0.5 mg, p less than 0.01). Scanning electron microscopy of debris from samples of whole blood, washed erythrocytes and platelet-rich plasma lased at 3 watts for 40 seconds documented the presence of membrane denaturation of blood elements, resulting in their fusion to form complex mesh-like conglomerates. Similar morphologic changes were observed in whole blood samples exposed to a "hot tip" rather than laser radiation. These data indicate that: 1) argon laser radiation with a power of 3 watts does not produce apparent hemolysis or debris formation for exposure periods up to 20 seconds, and 2) the effects of laser radiation on blood are probably mediated by thermal denaturation of cell membranes, as suggested by the same morphologic changes produced by thermal injury from a "hot tip."
使用氩激光使狭窄动脉再通可能需要将光束穿过血液。为了评估溶血程度和碎片形成情况，84份枸橼酸盐抗凝全血样本分别暴露于不同功率（1瓦、2瓦和3瓦）和持续时间（5秒、10秒、20秒和40秒）的氩激光辐射下。与对照样本相比，仅暴露于3瓦功率40秒的血样显示血细胞比容显著降低（从37±1.3降至33±1.4%，p<0.01），游离血红蛋白浓度（从0.2±0.2升至1.3±0.5 g/100 ml，p<0.01）和碎片重量（从0.9±0.3增至2.8±0.5 mg，p<0.01）均显著增加。对以3瓦功率照射40秒的全血、洗涤红细胞和富含血小板血浆样本中的碎片进行扫描电子显微镜检查，记录到血液成分存在膜变性，导致它们融合形成复杂的网状聚集体。在暴露于“热尖端”而非激光辐射的全血样本中也观察到了类似的形态学变化。这些数据表明：1）功率为3瓦的氩激光辐射在长达20秒的暴露时间内不会产生明显的溶血或碎片形成；2）激光辐射对血液的影响可能是由细胞膜的热变性介导的，这一点由“热尖端”热损伤产生的相同形态学变化所表明。
