CO2点阵激光联合308 nm准分子激光治疗稳定期白癜风的临床观察  

Fractionated CO2 laser combined with 308-nm excimer laser for the treatment of stable vitiligo： an observational clinical study

作　　者：孟丽亚[1] 王逸飞[2] 张春敏[1] 

机构地区：[1]山东大学第二医院皮肤科,济南250033 [2]山东大学医学院

出　　处：《中华皮肤科杂志》2014年第12期894-896,共3页Chinese Journal of Dermatology

基　　金：山东大学第二医院青年基金（Y20130L0076）

摘　　要：目的 观察CO2点阵激光联合308 nm准分子激光治疗稳定期白癜风的疗效和安全性.方法 49例稳定期白癜风患者109处皮损,每一处白斑沿最长直径平均分成两半,一半为治疗组,先进行点阵激光治疗,15 ～ 20 min后,整个白斑同时照射308 nm准分子激光;未行点阵激光的另一半为对照组.308 nm准分子激光每周照射2次,CO2点阵激光每2周1次,连续治疗观察12周,治疗结束3d后评价疗效.结果 治疗组与对照组总有效率分别为92.7％（101/109）和77.1％（84/109）.治疗组与对照组显效率在面颈部分别为85.4％（35/41）和65.8％（27/41）（r=4.23,P＜ 0.05）,躯干部分别为70.6％（24/34）和41.2％（14/34）（x2=7.27,P＜0.01）,四肢部位分别为64.0％（16/25）和36.0％ （9/25）（x2=3.92,P＜0.05）,手背部5/9和1/9（x2=4.00,P＜0.05）,差异均有统计学意义.治疗组与对照组治疗次数（以308 nm准分子激光治疗次数计算）比较：面颈部分别为（7.24±1.23）次和（10.81±2.01）次（t=9.70,P＜0.05）,躯干部分别为（15.10±2.47）次和（18.95±3.45）次（t=5.29,P＜0.05）,四肢部位分别为（17.37±3.84）次和（21.06±4.23）次（t 3.23,P＜0.05）,差异均有统计学意义.所有患者在治疗过程中均未出现严重不良反应.结论 CO2点阵激光联合308 nm准分子激光治疗白癜风有效而且安全.Objective To evaluate the efficacy and safety of fractionated CO2 laser combined with 308-nm excimer laser for the treatment of stable vitiligo.Methods Forty-nine patients with 109 lesions of stable vitiligo were enrolled in this clinical trial.Each of these lesions was equally divided into 2 parts along the longest diameter,which were then assigned into the treatment group and control group respectively.The treatment group were treated with fractionated CO2 laser radiation for 15-20 minutes once every two weeks combined with 308-nm excimer laser radiation twice weekly.The control group were only treated with 308-nm excimer laser radiation twice weekly.Efficacy was evaluated on day 3 after 12 consecutive weeks of treatment.Results After the treatment,the total response rate in the treatment group and control group was 92.7% （101/109） and 77.1% （84/109） respectively.The marked response rate in the treatment group and control group was 85.4% （35/41） and 65.8% （27/41） respectively for lesions on the face and neck （x2 =4.23,P 〈 0.05）,70.6% （24/34） and 41.2% （14/34） respectively for lesions on the trunk （x2 =7.27,P〈 0.01）,64.0% （16/25） and 36.0% （9/25） respectively for lesions on the extremities （x2 =3.92,P 〈 0.05）,5/9 and 1/9 respectively for lesions on the dorsal hands （X2 =4.00,P 〈 0.05）.The number of sessions of 308-nm excimer laser therapy required for the marked response of vitiligo in the treatment group and control group was 7.24 ± 1.23 and 10.81 ± 2.01 respectively for lesions on the face and neck （t =9.70,P 〈 0.05）,15.10 ± 2.47 and 18.95 ± 3.45 respectively for lesions on the trunk （t =5.29,P〈 0.05）,17.37 ± 3.84 and 21.06 ± 4.23 respectively for lesions on the extremities （t =3.23,P 〈 0.05）.No severe adverse reactions were observed in any of the patients during the treatment.Conclusion Fractionated CO2 laser combined with 308-nm excimer laser is effective and safe in treating stable vitiligo.

关 键 词：白癜风 点阵激光 疗效 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]