摘要
目的评估核素磷32联合光动力疗法(photodynamic therapy,PDT)对增生性瘢痕免疫应答及预后的影响。方法选取2018年1月至2019年1月,增生性瘢痕患者114例,随机分为对照组和观察组,每组患者57例。观察组采用核素磷32联合PDT治疗,光敏剂为5-氨基酮戊酸(5-Aminolevulinic acid,ALA),光照能量密度128 J/cm^(2),光照距离15 cm,每次照射时间20 min,每10 d进行一次治疗,四次为一个疗程;核素磷32贴2次,每次维持1个月。对照组仅行PDT治疗。治疗后2周,1、3和12个月采用温哥华瘢痕量表(vancouver scar scale,VSS)评分、判定临床疗效和复发情况,治疗前和治疗后2 d检测炎症因子和免疫功能指标。结果治疗后观察组患者的VSS评分较对照组有较快的下降(P<0.05),治疗后3个月对照组患者的VSS评分降为(9.91±2.0)分,而观察组患者VSS评分降为(6.59±1.3)分。治疗后12个月,观察组的有效率(96.5%)明显优于对照组(64.9%),差异具有统计学意义(P<0.05)。观察组治疗后12个月复发率明显低于对照组(P<0.05)。治疗后2d观察组各项炎症因子水平均低于对照组(P<0.05);观察组各免疫功能标志物(IgA、IgG和IgM)均优于对照组(P<0.05)。结论核素磷32联合PDT对增生性瘢痕治疗临床效果良好,能够明显降低患者的VSS评分,能同时抑制体内炎症反应,提高患者免疫功能,复发率较低。
Objective To evaluate the value of joint application of nuclide phosphorus 32 and photodynamic therapy(PDT)on the immune response and prognosis of hypertrophic scars.Methods Totally 114 patients with hypertrophic scars from Jan.2018 to Jan.2019 were selected and randomly divided into the control group and observation group,57 patients in each group.The patients in the observation group were treated jointly with nuclide phosphorus 32 and PDT.The photosensitizer used was 5-Aminolevulinic acid(ALA).For each treatment,the light energy density was set at 128 J/cm^(2),the light distance 15 cm,and the irradiation time 20 min.A course consisted of 4 treatments,which were given at an interval of 10 days.The nuclide phosphorus 32 was given twice at an interval of a month.Vancouver Scar Scale(VSS)was used to determine clinical efficacy and recurrence 2 weeks and 1,3,and 12 months after the treatment respectively.The changes to inflammatory factors and immune function indexes were detected respectively before and after the treatment.Results 2 weeks and 1,2 and 12 months after the treatment,the VSS score of the observation group decreased faster than that of the control group(P<0.05).The VSS score of the control group and observation group dropped to 9.91±2.0 and 6.59±1.3 respectively 3 months after the treatment.The clinical efficacy of the observation group was significantly better than that of the control group(P<0.05).After 12 months of treatment,the effective rate of the observation group was 96.5%while that of the control group being 64.9%.The recurrence rate in the observation group was significantly lower than that in the control group 12 months after the treatment(P<0.05).The levels of inflammatory factors in the observation group were lower than those of the control group(P<0.05)after the treatment.The immune function markers(IgA,IgG and IgM)of the observation group were better than those of the control group(P<0.05)after the treatment.Conclusions Combined application of nuclide phosphorus 32 and PDT has a good cl
作者
韩伟强
李丽莎
吴凌梅
陈誉华
陈云
聂蕴韬
魏雁
柴立超
张圣
HAN Weiqiang;LI Lisha;WU Lingmei;CHEN Yuhua;CHEN Yun;NIE Yuntao;WEI Yan;CHAI Lichao;ZHANG Sheng(Department of Medical Cosmetology,Xingtai People’s Hospital,Xingtai 054031,China;Department of Nuclear Medicine,Xingtai People’s Hospital,Xingtai 054031,China)
出处
《中国激光医学杂志》
CAS
2021年第6期324-329,共6页
Chinese Journal of Laser Medicine & Surgery
基金
河北省医学科学研究课题(20201572)。
关键词
核素磷32
光动力疗法
增生性瘢痕
免疫功能
Nuclide phosphorus 32
Photodynamic therapy
Hypertrophic scars
Immune functions
