510 nm激光用于光动力疗法治疗鲜红斑痣的疗效分析  

Clinical Analysis on Effect of 510 nm Laser in Photodynamic Therapy for Port Wine Stains

作　　者：顾瑛 王颖 谯煜 陈琦 周起蒙 马长勤 于祥升 GU Ying;WANG Ying;QIAO Yu;CHEN Qi;ZHOU Qimeng;MA Changqin;YU Xiangsheng(Department of Laser Medicine,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Laser Medicine Center,Hainan Hospital of Chinese PLA General Hospita;PrecisionLaserMedical Diagnosis and Treatment Innovation Unit,Chinese Academy of Medical Sciences;Qingdao Leishi Optoelectronics Technology Co.,Ltd.)

机构地区：[1]中国人民解放军总医院第一医学中心激光医学科,北京市100853 [2]中国人民解放军总医院海南医院激光医学中心 [3]中国医学科学院精准激光医学诊疗创新单元 [4]青岛镭视光电科技有限公司

出　　处：《中国激光医学杂志》2025年第1期7-11,共5页Chinese Journal of Laser Medicine & Surgery

基　　金：中国医学科学院医学与健康科技创新工程项目资助(2019-I2M-5-061)。

摘　　要：目的分析波长510 nm激光用于血管靶向光动力疗法(vascular-targeted photodynamic therapy,V-PDT)治疗鲜红斑痣(port wine stains,PWS)的临床疗效和安全性。方法选择2023年3至2024年11月就诊并治疗的PWS患者178例次,均行510 nm-PDT治疗。所有患者于V-PDT前按每千克体重1 mg的给药剂量经静脉注射血卟啉注射液,给药后即刻采用波长510 nm激光照射,功率密度100 mW/cm^(2),能量密度90~360 J/cm^(2)。治疗后随访评价和记录疗效与不良反应发生情况。结果510 nm-PDT对178例次PWS中的各型病变均有效,总有效率为100.0%。首次治疗与以往曾行治疗的病例之间疗效比较,差异无统计学意义(P>0.05);不同分型之间疗效比较,差异无统计学意义(P>0.05)。治疗后反应为局部水肿2~4 d,部分病例有结痂。避光期为10~35 d。无瘢痕、水疱、皮肤光敏反应等不良反应发生。结论波长510 nm激光作为激发光源用于V-PDT治疗鲜红斑痣安全、有效,可作为V-PDT选择性治疗PWS的新光源。Objective To analyze the clinical efficacy and safety of 510 nm laser photodynamic therapy for port wine stains(PWS).Methods A total of 178 cases PWS diagnosed and treated from March 2023 to November 2024 were selected,and all of them were treated with 510 nm-PDT.All patients were irradiated with 510 nm laser at the power density of 100 mW/cm^(2)and the energy density of 90-360 J/cm^(2)immediately after intravenous injection of photosensitizer(hematoporphyrin derivative,HpD)at 1 mg/kg body weight.The efficacy and adverse reactions were followed up.Results 510 nm-PDT was effective for all types of PWS in the 178 cases.The reactions after treatment included 2 to 4 days topical edema,scab formation in some cases.Strong light-avoiding period was 10 to 35 days.No serious adverse reactions such as scar,blister or skin photosensitivity occurred.Conclusions 510 nm laser can be used as a new exciting light source for the selective treatment of PWS with vascular-targeted photodynamic therapy.

关 键 词：激光 血管靶向光动力疗法 鲜红斑痣 激发光源 血卟啉衍生物 

分 类 号：R318.51[医药卫生—生物医学工程] R543[医药卫生—基础医学]