高频超声评估鼻唇沟填充后透明质酸的长效性和弥散模式的长期随访。
Long-Term Follow-Up of Longevity and Diffusion Pattern of Hyaluronic Acid in Nasolabial Fold Correction through High-Frequency Ultrasound.
机构信息
From the Department of Dermatology, Peking Union Medical College Hospital, and the Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College.
出版信息
Plast Reconstr Surg. 2019 Aug;144(2):189e-196e. doi: 10.1097/PRS.0000000000005848.
BACKGROUND
Injectable hyaluronic acid fillers have been widely applied in the clinical treatment of facial wrinkles. However, further information and clinical evidence concerning dermal changes and hyaluronic acid filler longevity after injection and diffusion pattern are limited.
METHODS
The authors evaluated the longevity and diffusion pattern of two hyaluronic acid fillers generated by different cross-linking technologies used in the treatment of nasolabial folds using high-frequency ultrasound. Forty-one subjects were treated with Restylane 2 and the remaining 41 were treated with Dermalax DEEP. Wrinkle severity rating scale score and high-frequency ultrasound evaluation of nasolabial folds were performed before and after the injection of hyaluronic acid filler. The ultrasound images were acquired and analyzed to determine dermal thickness and the shape and distribution of hyaluronic acid filler.
RESULTS
At 2 and 24 weeks from baseline, increased dermal thickness induced by hyaluronic acid filler treatment was not significantly different between groups. At 48 weeks after injection, increased dermal thicknesses of the Restylane 2 group (0.14 ± 0.12 mm) were much lower than those of the Dermalax DEEP group (0.20 ± 0.13 mm). Ultrasound examination revealed that hyaluronic acid materials form well-demarcated and hypoechogenic areas. Restylane 2 tended to form a more diffuse pattern, with multiple smaller bubbles, whereas Dermalax DEEP developed into a more localized configuration, with larger clumps.
CONCLUSIONS
This study is the first long-term assessment of nasolabial fold correction that reveals the performance of different hyaluronic acid materials in vivo and validates high-frequency ultrasound as a simple and rapid modality. Hyaluronic acid fillers generated by different cross-linking technologies display differential diffusion patterns in skin tissues.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
背景
注射用透明质酸填充剂已广泛应用于面部皱纹的临床治疗。然而，关于注射和扩散模式后真皮变化和透明质酸填充剂寿命的信息和临床证据有限。
方法
作者使用高频超声评估了两种不同交联技术产生的透明质酸填充剂在鼻唇沟治疗中的寿命和扩散模式。41 名受试者接受了瑞蓝 2 治疗，其余 41 名受试者接受了德玛莎 DEEP 治疗。在注射透明质酸填充剂前后，采用皱纹严重程度评分量表评分和高频超声对鼻唇沟进行评估。采集和分析超声图像以确定真皮厚度和透明质酸填充剂的形状和分布。
结果
与基线相比，在 2 周和 24 周时，两组之间由透明质酸填充剂治疗引起的真皮厚度增加没有显著差异。在注射后 48 周时，瑞蓝 2 组（0.14 ± 0.12mm）的真皮厚度增加明显低于德玛莎 DEEP 组（0.20 ± 0.13mm）。超声检查显示，透明质酸材料形成界限分明且低回声区域。瑞蓝 2 倾向于形成更弥散的模式，有多个较小的气泡，而德玛莎 DEEP 则形成更局限的形态，有较大的团块。
结论
本研究是首次对鼻唇沟矫正的长期评估，揭示了不同透明质酸材料在体内的性能，并验证了高频超声作为一种简单快速的方式。不同交联技术产生的透明质酸填充剂在皮肤组织中表现出不同的扩散模式。
临床问题/证据水平：治疗，II 级。
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