光动力学疗法治疗过程中鲜红斑痣病变组织内光敏剂含量检测的初步研究

Monitoring Photosensitizer Concentration Variation During Photodynamic Therapy of Port Wine Stain:a Preliminary Study

目的应用荧光光谱技术监测光动力学疗法治疗过程中鲜红斑痣病变组织内光敏剂含量的变化,分析光漂白产物的生成情况。方法鲜红斑痣患者静脉推注光敏剂PSD-007,即刻以532 nm倍频Nd∶YAG激光器作为光动力治疗光源照射病变组织,同时又作为光敏剂荧光激发光源。在不影响光照的前提下,应用光学多通道分析仪实时采集同一治疗区域不同时间点的荧光光谱。经过光谱分析与处理,得到治疗区局部组织光敏剂含量以及光漂白产物含量随治疗时间变化的曲线图。结果不同患者治疗区局部组织光敏剂荧光变化存在较大的个体差异,但是各病例均呈现先上升后降低的趋势,第1治疗区的最大荧光强度高于第2治疗区域,第1治疗区出现最高荧光峰的时间为治疗开始后的5～15 min。结论通过荧光手段监测光动力治疗时鲜红斑痣病变局部组织内光敏剂荧光的变化可有效地反映光敏剂含量的变化,对于了解光动力反应的进行情况以及预测反应效果具有一定的指导意义,并为制定个性化的光动力治疗方案提高疗效提供依据。

Objective To monitor the photosensitizer concentration and formation of photoproduct in local skin of patients with port wine stains by fluorescence spectroscopy during photodynamic therapy （PDT）. Methods After sensitivity test the patients with port wine stains were injected with photocarcinorin（PSD-007） intravenously. 532nm Double-frequency Nd ： YAG laser worked both as light source for photodynamic therapy and as excitation light source for fluorescence collection. The collection of fluorescence spectra was completed with optic muhichannel analyzer at different time points. The results of photosensitizer concentration and photoproduct generation were obtained by using spectroscopic analytical methods. Results Although there was considerable lesion-to-lesion variability between all the lesions tested, the photosensitizer fluorescence intensity rose at the beginning of treatment, and got peak fluorescence intensity after about 5 to 10 minutes, and began to decrease with time prolonging. The peak fluorescence intensity of the first light irradiation area was higher than that of the second one. Conclusions The fluorescence spectroscopic method established in this study can provide an efficient way to monitoring photosensitizer concentration and photoproduct generation during PDT. It will be helpful to optimize the dosimetry of PDT and to improve the treatment efficiency.