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三种不同干预措施矫正HIV相关面部脂肪萎缩的比较:一项前瞻性研究。

Comparison of three different interventions for the correction of HIV-associated facial lipoatrophy: a prospective study.

作者信息

Guaraldi Giovanni, Orlando Gabriella, De Fazio Domenico, De Lorenzi Ilario, Rottino Antonio, De Santis Giorgio, Pedone Antonio, Spaggiari Antonio, Baccarani Alessio, Borghi Vanni, Esposito Roberto

机构信息

HIV Metabolic Clinic, Department of Infectious and Tropical Diseases, University of Modena and Reggio Emilia, Italy.

出版信息

Antivir Ther. 2005;10(6):753-9.

Abstract

OBJECTIVE

To compare autologous fat transfer (AFT), injections of reabsorbable [polylactic acid (PLA)] and non-reabsorbable [polyacrylamide hydrogel (PAAG)] filler materials for the treatment of HIV-related facial lipoatrophy.

DESIGN AND METHODS

Eligible individuals with enough residual subcutaneous fat in the abdomen or in the dorso-cervical region were offered AFT surgery. Other individuals were blindly assigned to two different surgical teams, who administered a set of PLA or PAAG injections every 4 weeks. The primary endpoint was the measurement of Bichat's fat pad region, determined by the result of dermal plus subcutaneous thickness. Secondary endpoints included body image evaluation (determined by ABCD questionnaire), facial aesthetic satisfaction (determined by Visual Analogue Scale), and aesthetic pre- and post-picture comparisons by independent reviewers. All variables were measured at baseline and at 24 weeks after the last treatment session.

RESULTS

Twenty-four individuals received AFT and 35 were selectively randomized to PLA (20) or PAAG (15) infiltrations. PLA and PAAG groups received a mean of 5 and 6 injections respectively (P = NS). The mean change in dermal and subcutaneous thickness was 3.3 +/- 4.1 mm, 3.5 +/- 4.0 mm; 2.1 +/- 3.0 mm (P = 0.687), respectively. The mean change in ABCD score result was poorer in the AFT arm, but there were no other differences in other measured factors. Four serious adverse events were documented in the AFT arm only.

CONCLUSIONS

All three interventional techniques were highly effective in improving the aesthetic satisfaction of the patients. Longer follow-up is necessary to determine the most durable and suitable treatment.

摘要

目的

比较自体脂肪移植(AFT)、注射可吸收[聚乳酸(PLA)]和不可吸收[聚丙烯酰胺水凝胶(PAAG)]填充材料治疗HIV相关面部脂肪萎缩的效果。

设计与方法

符合条件且腹部或颈背部有足够残余皮下脂肪的个体接受AFT手术。其他个体被随机分配到两个不同的手术团队,每4周接受一组PLA或PAAG注射。主要终点是通过真皮加皮下厚度结果测定的比夏特脂肪垫区域。次要终点包括身体形象评估(由ABCD问卷确定)、面部美学满意度(由视觉模拟量表确定)以及由独立评审员进行的美学治疗前后图片比较。所有变量在基线和最后一次治疗后24周进行测量。

结果

24例个体接受了AFT,35例被选择性随机分配接受PLA(20例)或PAAG(15例)注射。PLA组和PAAG组分别平均接受5次和6次注射(P = 无显著差异)。真皮和皮下厚度的平均变化分别为3.3±4.1毫米、3.5±4.0毫米;2.1±3.0毫米(P = 0.687)。AFT组的ABCD评分结果平均变化较差,但在其他测量因素上没有其他差异。仅在AFT组记录到4例严重不良事件。

结论

所有三种干预技术在提高患者美学满意度方面都非常有效。需要更长时间的随访来确定最持久和合适的治疗方法。

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