双模式Nd：YAG激光治疗黄褐斑82例疗效及相关因素分析  

The clinical effect and related factors analysis of Cosjet TR laser on 82 cases of melasma

作　　者：夏栩琼[1] 费烨[1] 沈征宇[1] 陈向东[1] 

机构地区：[1]上海交通大学附属第九人民医院皮肤科、激光美容中心,上海200011

出　　处：《临床皮肤科杂志》2012年第9期567-570,共4页Journal of Clinical Dermatology

基　　金：上海市科委引导计划基金(08411968300)资助项目

摘　　要：目的:观察双模式Nd:YAG激光治疗黄褐斑的临床疗效以及相关影响因素。方法:应用双模式Nd:YAG激光治疗82例女性黄褐斑患者,总治疗次数为5次,每次间隔2周,治疗结束后由医生及受试者本人对激光治疗进行疗效评价,并随访12周记录复发情况,对各相关影响因素与治疗疗效进行统计学分析。结果:82例患者治疗前黄褐斑平均面积及严重程度指数(MASI)评分(12.58±6.55)分,5次激光治疗后降为(7.72±5.13)分,随访12周后的平均MASI评分为(8.14±5.82)分。Logistic回归分析显示Wood灯下分型(P=0.003,OR=6.062)、心境情况(P=0.027,OR=3.791)、防晒霜使用情况(P=0.003,OR=3.544)与疗效相关;而表皮型(P=0.025,OR=9.223)、心境平和(P=0.030,OR=6.757)、防晒霜使用情况(P=0.001,OR=9.702)、起病年龄(P=0.004,OR=8.937)与复发情况相关。结论:双模式Nd:YAG激光是治疗黄褐斑的有效手段。皮损表浅、保持心境平和、养成良好的防晒习惯是黄褐斑激光治疗疗效及降低复发的有利因素,起病年龄早是降低复发的有利因素。Objective： The clinical effect and related factors analysis of Cosjet TR laser on 82 cases of melasma. Methods： 82 female patients with melasma were given Cosier TR laser every 1-2 weeks for 5 times. After 12 weeks follow-up, the results of treatment were assessed by retrospective analysis of clinical photographs and patient satisfaction rates. Results： After laser treatment, the average of MASI score reduced from 12.58 ±6.55） to 7.72 ±5.13）, After 12 weeks of follow-up the average MASI score was 8.14 ±5.82）. Logistic regression analysis showed the associations of efficacy with Wood lamp type （P= 0.003, OR =6.062）, mood conditions （P= 0.027, OR= 3.791）, sunscreen used conditions （P= 0.003, OR = 3.544）. The recurrence was associated with epidermal type （P= 0.025, OR = 9.223）, good mood conditions （P= 0.030, OR = 6.757）, sunsereen used conditions （P= 0.001, OR = 9.702）, duration （P= 0.004, OR = 8.937）. Conclusion： Dual-mode Nd：YAG laser is an effective means of melasma treatment. Epidermal melasma, maintain peace of mind, good sun protection habits are favorable factors for efficacy and recurrence in laser treatment of melasma. And the age of onset early is a favorable factor for recurrence.

关 键 词：双模式Nd:YAG激光 黄褐斑 影响因素 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]