Kelly Kristen M, Kimel Sol, Smith Tia, Stacy Amy, Hammer-Wilson Marie J, Svaasand Lars O, Nelson J Stuart
Beckman Laser Institute, University of California, Irvine, California 92612, USA.
Lasers Surg Med. 2004;34(5):407-13. doi: 10.1002/lsm.20041.
The degree of port wine stain (PWS) blanching following pulsed dye laser (PDL) therapy remains variable and unpredictable. Because of the limitations of current PDL therapy, alternative treatment approaches should be explored. The objective was to evaluate a novel methodology for selective vascular damage, combined photodynamic (PDT) and photothermal (PDL) treatment, using the in vivo chick chorioallantoic membrane (CAM) model.
STUDY DESIGN/MATERIALS AND METHODS: Thirty microliters of benzoporphyrin derivative monoacid ring A (BPD) solution was administered intraperitoneally into chick embryos at day 12 of development. Study groups were: (1) control (no BPD, no light); (2) BPD alone; (3) continuous wave irradiation (CW) alone (576 nm, 60 mW/cm2, 125 seconds); (4) CW + PDL; (5) BPD+PDL; (6) PDT (BPD+CW); (7) PDL alone (585 nm, 4 J/cm(2)); and (8) PDT+PDL (BPD + CW followed immediately by PDL). Vessels were videotaped prior to, and at 1 hour post-intervention and then assessed for damage based on the following scale: 0, no damage; 1, coagulation; 1.5, vasoconstriction; 2.0, coagulation+vasoconstriction; 2.5, angiostasis; 3.0, hemorrhage. Damage scores were weighted by vessel "order."
PDT + PDL resulted in significantly (P < 0.01) more severe vascular damage than was observed in any other study group: 127% more than PDT, 47% more than PDL alone.
PDT + PDL is a novel and promising approach for selective vascular damage and may offer a more effective method for treatment of PWS and other vascular skin lesions.
脉冲染料激光（PDL）治疗鲜红斑痣（PWS）后的褪色程度仍存在差异且不可预测。鉴于当前PDL治疗的局限性，应探索其他治疗方法。目的是利用体内鸡胚绒毛尿囊膜（CAM）模型评估一种用于选择性血管损伤的新方法，即联合光动力（PDT）和光热（PDL）治疗。
研究设计/材料与方法：在发育第12天向鸡胚腹腔内注射30微升单酸环A苯并卟啉衍生物（BPD）溶液。研究组包括：（1）对照组（未注射BPD，未光照）；（2）仅BPD组；（3）仅连续波照射（CW）组（576纳米，60毫瓦/平方厘米，125秒）；（4）CW + PDL组；（5）BPD + PDL组；（6）PDT组（BPD + CW）；（7）仅PDL组（585纳米，4焦/平方厘米）；（8）PDT + PDL组（BPD + CW后立即进行PDL）。在干预前及干预后1小时对血管进行录像，然后根据以下标准评估损伤情况：0级，无损伤；1级，凝血；1.5级，血管收缩；2.0级，凝血 + 血管收缩；2.5级，血管生成抑制；3.0级，出血。损伤评分根据血管“级别”进行加权。
与其他任何研究组相比，PDT + PDL导致的血管损伤明显更严重（P < 0.01）：比PDT多127%，比仅PDL组多47%。
PDT + PDL是一种用于选择性血管损伤的新颖且有前景的方法，可能为治疗PWS和其他血管性皮肤病变提供更有效的方法。
