作　　者： (马少吟）; (田歆）; (高爱莉）; (陈智睿）; (朱慧兰）; (赖维）;

机构地区： 广州市皮肤病防治所,广东广州510095

出　　处： 《皮肤性病诊疗学杂志》 2017年第4期243-247,260,共6页

摘　　要： 目的:研究皮肤年轻化的治疗中点阵铒激光不同能量密度与疗效和不良反应之间的关系,探讨最佳治疗参数配置的规律,为临床操作提供指引。方法:24只雄性Wistar大鼠,将每只大鼠背部皮肤分成6块,随机选取5块采用不同能量密度点阵铒激光照射(40、60、80、100和120 mJ/cm^2组,简称LP40、LP60、LP80、LP100和LP120组),未照射区域为对照组。在照射后1 h、3 d、7 d和28 d分别取材做HE染色和免疫组化,测量不同能量密度照射大鼠皮肤后1 h微治疗带的宽度、深度与凝固带的厚度和照射后28 d真皮厚度;采用免疫组化测量HSP70、Caspase-3和TGF-β1的表达量;采用RT-PCR方法测量术后28 d Wistar大鼠皮肤Ⅰ型胶原mRNA的表达。记录术后出现的不良反应,包括有无出现红斑、水肿、色素沉着、瘢痕和渗出等,同时记录完全脱痂的天数。结果:在一定范围内(40~100 mJ/cm^2),点阵铒激光照射Wistar大鼠后各组间完全脱痂时间、微治疗带的深度、凝固带厚度、真皮的厚度、HSP70、Caspase-3、TGF-β1和Ⅰ型胶原mRNA的表达均不同;LP100组脱痂时间最长,微治疗带的深度、凝固带厚度、真皮厚度最厚,表达Ⅰ型胶原mRNA最多(P<0.05);LP80组照射后真皮厚度和TGF-β1的表达接近LP100组,完全脱痂时间低于LP100组。结论:在一定范围内(40~100 mJ/cm^2),点阵铒激光长脉宽模式照射Wistar大鼠的皮肤后,皮肤年轻化的疗效与能量密度及组织的损伤程度相关,取设备所推荐治疗用的能量密度(100 mJ/cm^2)的80%时,可以在取得满意治疗效果的同时,将组织损伤的程度和修复所需时间控制在更好的范围。临床操作时可以参照此数值设定最佳的能量密度。 Objective： To evaluate the relationship between the efficacy and side effects of frac-tional Er＊ YAG laser when using different energy density for skin resurfacing,and to provide a reli-able reference for operators. Methods ：The back skin of 24 male Wistar rats were shaved and di-vided into 6 areas. One area was served as control,and the others were treated with different ener-gy density,such as 40, 60, 80,100 and 120 mj/cm2 with the same pulse width mode. The biopsyspecimen would be taken at 1 hour post treatment and so that the width and depth treatment zones （ MTZ）, thickness of coagulation band 1 hour post treatment,the dermal thick-ness of those specimens 28 day post treatment could be compared. The expres[Abstract] Objective： To evaluate the relationship between the efficacy and side effects of frac-tional Er＊ YAG laser when using different energy density for skin resurfacing,and to provide a reli-able reference for operators. Metll〇d s ：The back skin of 24 male Wistar rats were shaved and di-vided into 6 areas. One area was served as control,and the others were treated with different ener-gy density,such as 40, 60, 80,100 and 120 mj/cm2 with the same pulse width mode. The biopsyspecimen would be taken at 1 hour post treatment and so that the width and depth treatment zones （ MTZ）, thickness of coagulation band 1 hour post treatment,the dermal thick-ness of those specimens 28 day post treatment could be compared. The expres protein 70 （HSP70） , Caspase3 and transforming growth factor-（3l （TGF-J31） were investigated by means of immunohistochemistry. The expression of collagen type I on the day 28 after treatment was detected by RT-PCR. The side effects , such as erythema , edema , hyperpigmentation , scarsand weeping were observed simultaneously. Results： Within certain range （ 40 -100 mJ/cm2 ）,there was a significant difference with the time of decrustation , the depth of MTZ , the width ofthermal coagulation , the thickness of the de

关 键 词： 铒激光 能量密度 型胶原 年轻化 不良反应