Q开关紫翠宝石激光治疗602例太田痣临床分析及超微结构观察  

Analysis of 602 Cases of Nevus of Ota and Study of Ultrastructures on the Melanocytes

作　　者：王宏伟[1] 王家璧[1] 刘跃华[1] 方凯[1] 姜国调[1] 左亚刚[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院皮肤科,北京100730

出　　处：《中国医学科学院学报》2003年第5期590-593,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的统计分析602例太田痣的临床资料及疗效,观察治疗前后太田痣真皮黑素细胞的组织病理和超微结构的特点。方法采用临床登记、核对照片、问卷的形式,收集太田痣临床资料602例。对10例太田痣进行治疗前后组织病理观察,6例太田痣进行治疗前后超微结构观察。结果太田痣发病分为先天性和后天性,后者发病主要在青春期,以浅褐色或浅蓝色为主;病变最常累及的部位是颧部、颞部及下眼睑。多元回归分析显示,采用Q开关紫翠宝石激光治疗太田痣,治疗6次有效率达85.20%,痊愈率达55.72%;治疗9次时有效率达100%,痊愈率达98.46%。统计结果表明,影响疗效的因素与是否有眼睑受累和Tanino分级有关。电镜观察显示,太田痣真皮黑素细胞含较多成熟黑素体,大小不一;激光照射后即刻可见黑素体崩解,黑素细胞内密集细小颗粒;临床皮损消退后,真皮胶原纤维间未见黑素体。结论Q开关紫翠宝石激光治疗太田痣患者安全、有效,疗效与部位和受累面积有关。激光可选择性破坏太田痣真皮黑素细胞而对周围组织损伤小。To analyze clinical information and efficacy of602cases of nevus of Ota,and investigate the histopathology and ultrastructure on the melanocytes before and after Q-switched Alexan-drite laser irradiation.Methods Clinical information of602cases of nevus of Ota were collected by applying clinical records,checking photos,and inquiry to patients by letters and telephones.Ten cases of biopsies were observed by light microscopy and6cases by electron microscopy before and after laser irradiation.Results Nevus of Ota included congenital and acquired cases.Skin lesions mainly occurred in adolescence for the acquired cases.The main colours of lesions were brown and blue.The most local lesions were zygomata,temporal regions,and lower eyelids.According to multiple regression,the more treatment times,the better results.The effective rate was85.20%and100%after6and9treatment times,respectively,while the cure rate was55.72%and98.46%,respectively.The eyelids involved and Tanino types influenced the treatment times by COX models analysis.Electron microscopy showed many melanosomes in the dermal melanocytes.After laser irradiation,the outlines of the dermal melanocytes were observed,the melanosomes were broken to dense and tiny granules.Conclusions Q-switched Alexandrite laser is safe and effective for the treatment of nevus of Ota.The results of treatment are correlated with the area and size of the lesion.The dermal melanocytes in nevus of Ota can be selectively destroyed by Q-switched Alexandrite laser with less injury around tissues.

关 键 词：太田痣 Q开关紫翠宝石激光 超微结构 

分 类 号：R751[医药卫生—皮肤病学与性病学]