不同激光参数照射下血管中血栓的演变

目前,激光是治疗葡萄酒色斑(Port Wine Stain,PWS)最有效的疗法。然而,由于选择性光热效应机理研究的欠缺,PWS的临床彻底清除率依然很低(<20%)。本文利用鼠脊视窗模型研究了不同激光参数照射下血管中光凝块和血栓的演变规律,以期为开发新的治疗策略提供依据。实验结果表明,Nd:YAG激光(1064 nm)照射后血管中只出现光凝块。长脉宽532nm激光照射后血管中首先形成光凝块,随着光凝块的流走,血栓产生并粘着血管壁。血栓面积随时间先增大后减小,存在时间长达4 h以上。短脉宽532 nm激光照射后,则形成非粘着血管壁血栓并随血流流走。由于形成完全堵塞血管的血栓是清除血管的前提,长脉宽532 nm激光联合抗血栓药物治疗PWS有望改善激光治疗PWS疗效。

The Evolution of Thrombus in Blood Vessels Irradiated by Laser Light With Different Laser Parameters

At present,the most effective method for treating Port Wine Stain(PWS)is laser therapy.However,the complete clearance rate of PWS is still less than 20%,owing to the lack of the study on thermal response mechanism.Herein,the evolution of photocoagulation and thrombus formation in blood vessels was studied using dorsal skin chamber model irradiated by laser with different parameters,in order to promote the development of novel treatment strategies.The results showed that only photocoagulation occurred in blood vessels irradiated by Nd:YAG laser with a wavelength of 1064 nm.After the irradiation by 532 nm laser with long pulse duration,photocoagulation initially formed in the blood vessels,and then photocoagulation flowed away and thrombus adhered to blood vessel wall.The area of thrombus increases with time initially and then decreases.Besides,the thrombus existed in blood vessels for longer than 4 hours.After the irradiation by 532 nm laser with short pulse duration,the thrombus which was not adhered to blood vessels wall formed,and then flowed away.Since the thrombus that completely occludes the vessel lumen is the prerequisite for optimal clinical outcome,532 nm laser with long pulse duration combined with antithrombotic drugs is promising to improve the efficacy of the laser treatment for PWS.