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[紫外线照射血液疗法(UVB)治疗重度心绞痛及其多种作用机制]

[Therapy of severe stenocardia with ultraviolet blood irradiation (UVB) and various action mechanisms of this therapy].

作者信息

Ganelina I E, Kukui L M, Nikolaewa J P, Schumilowa T E, Cholmogorow W E, Timofeew K W, Schurigin A L

出版信息

Folia Haematol Int Mag Klin Morphol Blutforsch. 1982;109(3):470-82.

PMID:6182067
Abstract

We observed 70 male patients with a seriously proceeding Chronic myocardial ischemia. They were hospitalised because of frequent, permanent and serious attacks of stenocardia at rest and in stress situations. More than 2/3 of these patients had suffered from a myocardial infarct. In the course of two weeks an intensive therapy with all modern preparations for vasodilatation was made. This therapy proved to be unsuccessful. Nearly all patients were administered more than 10 tables of nitroglycerin per day and, in addition, they were injected analgetics as a compensation of attack. The ultraviolet own blood irradiation (UVB) had a positive therapeutic effect in all patients. There was a good success in 46 patients, in all patients satisfactory results could be registered. The effect of therapy was evident by the decrease of administration of nitroglycerin required, by an increase in the degree of stress capacity, and by an easier treatment of stenocardia attacks. The observation time for patients amounted to 2-8 months. The success of therapy remained in 38 patients. After this time the success of therapy could partially be regained by a repeated number of irradiation series. Then, it remained positive in 9 of 22 patients who had been followed-up for 10 months. The half decay period of eliminating 131I from an intradermal depot could be normalised under the influence of ultraviolet own blood irradiation. This ultraviolet own blood irradiation had no significant influence on the fibrinogen level, fibrinolytic activity, and erythrocyte aggregation (examined in 11 patients). A 2 1/2-fold diminution of monomer fibrin complexes in the blood could be observed. The titre of antistreptolysin-O was increased in all patients who had got over the infarct. It had completely normalised a week after finishing the ultraviolet own blood irradiation. Spectroscopic examinations of the blood and plasma made after ultraviolet own blood irradiation revealed that this irradiation will not only affect the properties of Hb, but will also cause a photochemical transformation accompanied by a destruction of some plasma proteins, of the membrane of formed blood elements, and a photosynthesis of biochemically active compounds. The mechanism of action of ultraviolet own blood irradiation is complicated and requires further exact investigations. Even today, however, this method can be recommended as a complex therapy in patients with severe myocardial ischemia.

摘要

我们观察了70例患有严重进行性慢性心肌缺血的男性患者。他们因静息和应激状态下频繁、持续且严重的心绞痛发作而住院。这些患者中超过2/3曾患过心肌梗死。在两周内,采用了所有现代血管扩张制剂进行强化治疗。但该治疗被证明是不成功的。几乎所有患者每天服用超过10片硝酸甘油,此外,还注射镇痛药以缓解发作。自血紫外线照射(UVB)对所有患者都有积极的治疗效果。46例患者取得了良好的疗效,所有患者均有满意的结果。治疗效果通过所需硝酸甘油用量的减少、应激能力的提高以及心绞痛发作更易于治疗得以体现。患者的观察时间为2至8个月。38例患者维持了治疗效果。此后,通过重复多次照射系列,部分患者可再次获得治疗效果。之后,在随访10个月的22例患者中,9例患者的治疗效果仍为阳性。自血紫外线照射可使皮内注射部位131I的消除半衰期恢复正常。这种自血紫外线照射对纤维蛋白原水平、纤溶活性和红细胞聚集(在11例患者中检测)没有显著影响。可观察到血液中单体纤维蛋白复合物减少了2.5倍。所有患过心肌梗死的患者抗链球菌溶血素-O滴度均升高。在完成自血紫外线照射一周后,其完全恢复正常。自血紫外线照射后对血液和血浆进行的光谱检查表明,这种照射不仅会影响血红蛋白的性质,还会引起光化学转化,同时伴随着一些血浆蛋白、血液有形成分的膜的破坏以及生物活性化合物的光合作用。自血紫外线照射的作用机制复杂,需要进一步精确研究。然而,即便在今天,这种方法仍可作为重症心肌缺血患者的综合治疗方法予以推荐。

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