北京大学学报(医学版) ›› 2022, Vol. 54 ›› Issue (2): 283-288. doi: 10.19723/j.issn.1671-167X.2022.02.014
WANG Xiang-xi,LI Zhen-zhen,LAI Yan-yun,YANG Li,SHI Lin-li,ZHONG Shao-min,WU Yan()
摘要:
目的: 评价585 nm Q开关激光对于痤疮炎症性皮损和炎症后红斑的疗效和安全性。方法: 入选25例面部中度痤疮患者(Ⅱ~Ⅲ级,要求面部两侧均有一定的炎症性皮损和炎症后红斑), 其中共22例患者完成全部治疗及评价,3例患者失访。使用585 nm Q开关激光治疗随机选取的一侧面部,每次治疗间隔2周,共治疗3次。患者于每次治疗当日治疗前及末次治疗后2周、末次治疗后4周进行评价,即评价时间点分别为治疗前、第2周、第4周、第6周、第8周,共评价5次。每次评价采用研究者总体评估(investigator’s global assessment, IGA)评分及研究者红斑主观评分评价痤疮严重程度及红斑程度,使用窄谱反射分光光度计判断红斑程度。结果: 经3次治疗后,治疗侧第8周与治疗前比较的IGA评分差异有统计学意义(Z=2.64, P<0.01),对照侧第8周与治疗前比较的IGA评分差异有统计学意义(Z=2.67,P<0.01),治疗前及第8周治疗侧与对照侧比较的IGA评分差异均无统计学意义(P=0.59,P=0.26)。治疗侧第8周与治疗前比较的红斑主观评分差异有统计学意义(Z=4.24,P<0.01),对照侧前后红斑主观评分差异无统计学意义(Z=1.73,P=0.08), 第8周治疗侧研究者红斑主观评分低于对照侧(Z=3.61, P<0.01)。治疗侧5个时间点间红斑指数差异有统计学意义(P<0.01), 第8周与治疗前比较差异具有统计学意义(P<0.01), 对照侧5个时间点红斑指数差异无统计学意义。皮损治疗不良反应包括治疗后即刻局部出现轻度红斑、水肿,治疗中轻至中度疼痛,均于1~3 d内自行消退。9例患者评价为非常满意,7例患者评价为满意,6例患者评价为一般。结论: 585 nm Q开关激光对于改善痤疮炎症后红斑有一定效果,该治疗耐受度较高,安全性较好,对于痤疮炎症性皮损的改善治疗侧与对照侧差异无统计学意义。
中图分类号:
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