EFFECT OF LASER RADIATION ON ADENOSINE DEAMINASE CONCENTRATION IN PLEURAL FLUID

Abstract

The aim of this study was to investigate effects of low-intense laser irradiation (intravenous, intrapleural and combined) on adenosine deaminase (ADA) concentration in the pleural fluid of patients with pleural effusion of various etiology. Materials and methods. We examined patients aged 30 to 80 years with pleural effusion ( n = 45; 25 males (55.6 %), 20 females (44.4 %); the mean age, 67.6 ± 13.9 years). The cause of the pleural effusion was pneumonia ( n = 14), trauma ( n = 2) or chronic heart failure ( n = 29). All patients were randomly divided in a control group ( n = 17) or laser treatment group ( n = 28). The control group patients received standard treatment according to etiology of the effusion. The laser group patients were treated with laser and medications. Laser was applied using "Matrix-VLOK" device (Matrix, Russia) with the wave length of 0.365 μm and output of 1.0 – 1.5 mWt. Laser therapy was administered in continuous irradiation mode; course duration was 3 to 7 sessions in dependence on a rate of the fluid accumulation in the pleural cavity, in every other day. Intravenous laser irradiation was performed for 10 min after cubital vena puncture with a needle with KIVL-01 light-guide fiber. Intrapleural laser irradiation was performed for 10 min after pleurocentesis with the needle and light-guide fiber following pleural fluid suction and instillation of a wide-spectrum antibiotic solution. The pleural fluid was centrifuged during 10 min in 1,500 g and then was freezed in –20 °С until the examination. Studied parameters were measured before and after the treatment. Results. The laser group patients demonstrated a significant decrease in ADA concentration compared to baseline (25.30 ± 1.56 and 18.70±1.94МЕ × l–1 before and after treatment, respectively). The laser therapy in addition to the standard treatment was also related to clinical improvement. In controls the standard medication therapy did not lead to any change in ADA concentration (25.70 ± 1.63 and 22.80 ± 1.98 МЕ × l–1 before and after treatment, respectively). Conclusion. The results showed that in patients with pleural effusion the laser therapy in addition to the standard treatment was related to decrease in ADA concentration, slower fluid accumulation in the pleural cavity and shorter treatment duration. Time to the second pleural puncture was longer, the need in drug therapy was diminished and the treatment efficacy was higher in the laser treatment group. These effects led to improving quality of life and was thought to make the laser therapy rational in patients with pleural effusion of various etiology.