光动力治疗光线性角化病临床应用进展  

Progess of Photodynamic Therapy in the Treatment of Actinic Keratosis

作　　者：李建丹 王佩茹 王秀丽[1] LI Jiandan;WANG Peiru;WANG Xiuli(Institute of Photomedicine,Shanghai Skin Disease Hospital,Tongji University School of Medicine,Shanghai 200443,China)

机构地区：[1]上海市皮肤病医院,同济大学医学院光医学研究所,上海200443

出　　处：《皮肤科学通报》2023年第2期164-173,共10页Dermatology Bulletin

基　　金：国家重点研发计划(2022YFC2504705);国家自然科学基金资助面上项目(82073013);申康临床诊疗技术规范化管理和推广项目(SHDC22021216)。

摘　　要：光线性角化病(actinic keratosis,AK)是一种临床常见的癌前病变,多好发于曝光部位,常伴区域性癌化,可进展为鳞状细胞癌,在临床上需积极干预、全程管理。光动力疗法(photodynamic therapy,PDT)是AK常用的治疗方式之一,通过利用光敏剂和特定波长的光在氧的作用下发生光动力效应,通过直接杀伤、免疫调节等作用清除AK皮损以及亚临床皮损。PDT治疗AK有效安全、美容效果好,特别适合于头面部、多发、面积大的皮损及区域性癌化。PDT治疗AK可用红光、蓝光、日光、强脉冲光等多种光源激发,其中改良无痛红光PDT通过调整敷药时间、光照剂量等参数以降低治疗过程中的疼痛,在不影响疗效的前提下,提高患者的耐受性,充分发挥了PDT治疗AK的优势。本文将简要介绍PDT治疗AK的作用机制,详细阐述治疗参数、区域性面治疗理念,对比不同类型光动力的疗效及安全性,全面了解PDT治疗AK的临床应用进展。Actinic keratosis(AK)is a common clinical precancerous disease,mostly occurring at the exposure place,often accompanied by regional carcinoma,and can progress to squamous cell carcinoma,which requires active intervention and whole-process management in the clinic.Photodynamic therapy(PDT)is a commonly used AK treatment.It uses photosensitizers and specific wavelengths of light to generate a photodynamic effect under oxygen to eliminate AK lesions and subclinical lesions through direct killing and immune regulation.PDT is effective,safe,and has a good beauty effect in the treatment of AK,especially suitable for the head and face,multiple,large areas of skin lesions and field cancerization.PDT treatment of AK can be stimulated by red light,blue light,daylight,intense pulsed light,and other light sources.Among these,the modified red light PDT can reduce the pain in the treatment process by adjusting the dressing time,illumination dose and other parameters,and improve patients′tolerance without affecting the curative effect,giving full play to the advantages of PDT treatment of AK.In this review,we will briefly introduce the mechanism of PDT in treating AK,elaborate on the treatment parameters and field therapy concept,compare the efficacy and safety of different types of photodynamics,and comprehensively understand the clinical application progress of PDT in the treatment of AK.

关 键 词：光动力 光线性角化病 区域性面治疗 

分 类 号：R758.1[医药卫生—皮肤病学与性病学]