Lin Yanyan, Gong Wei, Kang Jie, Fang Yuhong, Liu Jingjing, Lin Lihang, Xiao Xuemin
Department of Dermatology, The Union Hospital, Fujian Medical University, Fuzhou, China.
Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, College of Photonic and Electronic Engineering, Fujian Normal University, Fuzhou, China.
Front Med (Lausanne). 2022 Feb 24;9:800836. doi: 10.3389/fmed.2022.800836. eCollection 2022.
Hemoporfin-mediated photodynamic therapy (HMME-PDT) is reported to be effective and safe for port-wine stains (PWS). However, its efficacy is influenced by several factors and there is no appropriate method to evaluate efficacy so far. Therefore, this study explored the clinical efficacy of HMME-PDT for PWS on the face and neck and the feasibility of evaluating treatment potency with optical coherence tomography (OCT).
A total of 211 PWS patients subjected to HMME-PDT were recruited for study and correlations of therapeutic effect with treatment sessions, age, gender, lesion distribution and treatment history analyzed. OCT was utilized for quantitative analysis of PWS lesions of 36 selected patients before and after HMME-PDT.
The efficacy of two consecutive treatments was significantly higher than that of single treatment ( < 0.05). In multivariate analysis, after the first treatment, age, lesion distribution and treatment history were correlative factors affecting treatment efficacy ( < 0.05). The improvement effect on central facial lesions was lower than that on lateral facial lesions ( < 0.05). The efficacy of therapy on the group with no history of pulsed dye laser (PDL) treatment was greater than that on effective and ineffective treatment groups ( < 0.05). After the second session, age remained the only factor correlated with efficacy ( < 0.05). Dilated vessel diameter and depth before and after treatment were significantly different ( < 0.05). With increasing treatment times, age was the most significant factor influencing treatment efficacy.
Our collective findings indicate that HMME-PDT therapy is effective and safe for PWS and support the utility of OCT in objective assessment of the efficacy of HMME-PDT.
据报道，血卟啉介导的光动力疗法（HMME-PDT）治疗鲜红斑痣（PWS）有效且安全。然而，其疗效受多种因素影响，且目前尚无合适的疗效评估方法。因此，本研究探讨了HMME-PDT治疗面颈部PWS的临床疗效以及利用光学相干断层扫描（OCT）评估治疗效果的可行性。
共招募211例接受HMME-PDT治疗的PWS患者进行研究，分析治疗效果与治疗次数、年龄、性别、病变分布及治疗史的相关性。对36例入选患者在HMME-PDT治疗前后利用OCT对PWS病变进行定量分析。
连续两次治疗的疗效显著高于单次治疗（<0.05）。多因素分析显示，首次治疗后，年龄、病变分布及治疗史是影响治疗效果的相关因素（<0.05）。面部中央病变的改善效果低于面部外侧病变（<0.05）。未接受过脉冲染料激光（PDL）治疗组的治疗效果优于有效和无效治疗组（<0.05）。第二次治疗后，年龄仍是与疗效相关的唯一因素（<0.05）。治疗前后扩张血管的直径和深度有显著差异（<0.05）。随着治疗次数增加，年龄是影响治疗效果的最显著因素。
我们总的研究结果表明，HMME-PDT治疗PWS有效且安全，并支持OCT在客观评估HMME-PDT疗效中的应用。
