Krupka Magdalena, Bożek Andrzej, Bartusik-Aebisher Dorota, Cieślar Grzegorz, Kawczyk-Krupka Aleksandra
Clinical Department of Internal Medicine, Dermatology and Allergology, Medical University of Silesia, Katowice, M. Sklodowskiej-Curie 10, 41-800 Zabrze, Poland.
Department of Internal Medicine, Angiology and Physical Medicine, Centre for Laser Diagnostics and Therapy, Medical University of Silesia, Katowice, Batorego 15, 41-902 Bytom, Poland.
Antibiotics (Basel). 2021 Apr 29;10(5):506. doi: 10.3390/antibiotics10050506.
Chronic and infected leg ulcers (LUs) are painful, debilitating, resistant to antibiotics, and immensely reduce a patient's quality of life. The purpose of our study was to demonstrate the efficacy of photodynamic therapy (PDT) for the treatment of infected chronic LUs. Patients were randomized into two experimental groups: the first group received 5-aminolevulinic acid photodynamic therapy (ALA-PDT) (10 patients), and the second group of 10 patients received local octenidine dihydrochloride (Octenilin gel) exposed to a placebo light source with an inserted filter that mimiced red light. In the PDT group, we used 20% ALA topically applied for 4 hrs and irradiation from a Diomed laser source with a wavelength of 630 nm at a fluency of 80 J/cm. ALA-PDT was performed 10 times during a 14-day hospitalization in 10 patients of both sexes aged 40-85 years with chronic leg ulcers. Treatments were carried out at 3-week intervals for 3-5 cycles. At 8-month follow-up with the PDT group, complete remission (CR) was obtained in four patients (40%), partial response (>50% reduction in ulcer diameter) in four patients (40%), and no response in two patients (20%) who additionally developed deterioration of the local condition with swelling, erythema, and inflammation. To assess the degree of pain during the trials, we used a numeric rating scale (NRS). From the preliminary results obtained, we concluded that PDT can be used to treat leg ulcers as a minimally invasive and effective method with no serious side effects, although further studies on a larger group of patients with LUs are warranted.
慢性感染性腿部溃疡（LUs）疼痛、使人虚弱、对抗生素耐药，极大地降低了患者的生活质量。我们研究的目的是证明光动力疗法（PDT）治疗感染性慢性腿部溃疡的疗效。患者被随机分为两个实验组：第一组接受5-氨基酮戊酸光动力疗法（ALA-PDT）（10例患者），第二组10例患者接受局部二盐酸奥替尼啶（Octenilin凝胶），并暴露于插入模拟红光滤光片的安慰剂光源下。在PDT组中，我们局部应用20%的ALA 4小时，并使用波长为630 nm、能量密度为80 J/cm的Diomed激光源进行照射。在14天的住院期间，对10例年龄在40 - 85岁的慢性腿部溃疡患者（男女皆有）进行了10次ALA-PDT治疗。治疗每隔3周进行一次，共进行3 - 5个周期。在对PDT组进行8个月的随访时，4例患者（40%）完全缓解（CR），4例患者（40%）部分缓解（溃疡直径缩小>50%），2例患者（20%）无反应，且这2例患者局部病情恶化，出现肿胀、红斑和炎症。为了评估试验期间的疼痛程度，我们使用了数字评分量表（NRS）。从获得的初步结果来看，我们得出结论，PDT可作为一种微创且有效的方法用于治疗腿部溃疡，且无严重副作用，不过有必要对更多腿部溃疡患者进行进一步研究。
