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一项关于采用两种测量方法的光动力疗法治疗的人类糖尿病溃疡病灶区域宏观形态测量学的研究。

A Study on the Macroscopic Morphometry of the Lesion Area on Diabetic Ulcers in Humans Treated with Photodynamic Therapy Using Two Methods of Measurement.

作者信息

Carrinho Patrícia Michelassi, Andreani Dora Inés Kozusny, Morete Vislaine de Aguiar, Iseri Shizumi, Navarro Ricardo Scarparo, Villaverde Antonio Balbin

机构信息

1 Biomedical Engineering Program, Brazil University , Fernandópolis, Brazil .

2 Faculty of Medicine, Brazil University , Fernandópolis, Brazil .

出版信息

Photomed Laser Surg. 2018 Jan;36(1):44-50. doi: 10.1089/pho.2017.4305. Epub 2017 Oct 9.

Abstract

BACKGROUND

Diabetes Mellitus is a chronic disease that can lead to lower-limb ulceration. The photodynamic therapy (PDT) is based on light interaction with a photosensitizer capable to promote bacterial death and acceleration of wound healing.

OBJECTIVE

This study aims to accomplish a macroscopic morphometry evaluation on diabetic ulcer area in humans that were under PDT.

MATERIALS AND METHODS

A clinical study was conducted by convenience sample, experimental, controlled, and blinded, composed of 12 patients of both sexes with diabetic ulcers in lower limbs that were divided into two groups, control (n = 6) and PDT (n = 6). They were all treated with collagenase/chloramphenicol during the experimental period, in which six of them had received PDT with Methylene Blue dye (0.01%) associated with laser therapy (660 nm, 30 mW, 8 sec, 6 J/cm, beam area of 0.04 mm), three times per week, totaling 10 sessions. Ulcer areas were analyzed by their nominal area and photographed for analysis through the ImageJ software. Then, the Ulcer Healing Index and the wound area reduction were calculated for both groups.

RESULTS

Data from the UHI and wound area reduction parameters show that there is a statistically significant difference (p < 0.05) between the control group and PDT group, with the PDT group showing a greater reduction of the diabetic ulcer area than the control group. In the ImageJ software area analysis, both patient groups presented significant differences (p < 0.05) between pre and post-treatment in relation to lesion reduction area, the PDT being better.

CONCLUSIONS

Results show that PDT accelerates the closure of ulcer wounds and to evaluate the wound area, different measurement methods can be used to follow-up the tissue repair process.

摘要

背景

糖尿病是一种可导致下肢溃疡的慢性疾病。光动力疗法(PDT)基于光与一种能够促进细菌死亡和加速伤口愈合的光敏剂的相互作用。

目的

本研究旨在对接受光动力疗法的人类糖尿病溃疡区域进行宏观形态计量学评估。

材料与方法

采用便利抽样、实验性、对照性和双盲的临床研究,纳入12例患有下肢糖尿病溃疡的男女患者,分为两组,对照组(n = 6)和光动力疗法组(n = 6)。在实验期间,两组患者均接受胶原酶/氯霉素治疗,其中6例接受了亚甲蓝染料(0.01%)联合激光治疗(660 nm,30 mW,8秒,6 J/cm,光束面积0.04 mm)的光动力疗法,每周3次,共10次。通过标称面积分析溃疡区域,并拍照通过ImageJ软件进行分析。然后,计算两组的溃疡愈合指数和伤口面积减少情况。

结果

溃疡愈合指数和伤口面积减少参数的数据表明,对照组和光动力疗法组之间存在统计学显著差异(p < 0.05),光动力疗法组的糖尿病溃疡面积减少幅度大于对照组。在ImageJ软件面积分析中,两组患者在治疗前后的病变减少面积方面均存在显著差异(p < 0.05),光动力疗法组效果更好。

结论

结果表明,光动力疗法可加速溃疡伤口的闭合,并且为评估伤口面积,可使用不同的测量方法来跟踪组织修复过程。

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