308nm准分子激光治疗36例白癜风临床疗效观察

Excimer Laser of 308nm in Treatment of Vitiligo and Its Clinial Efficacy

目的观察308 nm准分子激光治疗白癜风的临床疗效及安全性。方法白癜风患者36例44块皮损,应用308 nm准分子激光(脉冲时间20～40μms,脉冲能量密度6.5 J/cm2,频率200 Hz,光斑直径10、20和25 mm)对皮损进行照射,每周治疗2次,连续治疗30次。治疗后3和6个月进行随访,评价疗效和安全性。结果(1)10、20、30次治疗结束后,有效率分别为31.9%(14/44)、59.1%(26/44)、70.5%(31/44)。(2)30次治疗结束后,面颈部、躯干和四肢有效率分别为74.1%(20/27)、100.0%(9/9)和25.0%(2/8),面颈部和躯干的有效率明显高于四肢(P<0.05)。面颈部、躯干和四肢平均累积照射剂量分别是(7.92±5.26)、(9.93±7.36)和(22.13±8.15)J/cm2。面颈部和躯干的患者的平均累积照射剂量均明显低于四肢(P<0.05)。(3)面颈部白癜风患者病程在2年以内和超过2年的有效率分别为100.0%(14/14)和46.2%(6/13),前者的有效率明显高于后者(P<0.05)。结论308 nm准分子激光治疗白癜风安全、有效。

Objective To investigate the clinical efficacy and safety of 308 nm excimer laser in the treatment of vitiligo. Methods Thirty-six patients with vitiligo were treated by a 308 nm excimer laser which was performed two times per week and continued totally I year for 30 times. Follow-ups were scheduled on 3 and 6 months after the treatment. The therapeutic effect and safety were evaluated. Results （ 1 ）After 10,20 and 30 times of treatment, the effective rate of 36 patients with vitiligo was 31.9%, 59. 1% and 70. 5%, respectively. （2）After 30 times of treatment, the improved rate of vitiligo in face-neck, trunk and extremities was 74. 1% , 100. 0% and 25. 0% , respectively. The rate in face-neck and trunk was higher than in extremities（ P 〈 0. 05 ）. The improved rate in course of diseases ≤2 years and 〉2 years was 100. 0% and 46. 2% , respectively. The rate in course of diseases ≤2 years was higher than in 〉 2years （ P 〈 0. 05 ）. （ 3 ） After 30 times of treatment, the average cumulative dose of excimer laser in face-neck, trunk and extremities was （7. 92±5. 26） J/cm^2, （9.93 ± 7. 36） J/cm^2 and （22. 13 ± 8.15） J/cm^2, respectively. The dose in face-neck and trunk was lower than in extremities （ P 〈 0. 05 ）. Conclusions The clinical data demonstrate that the treatment of 308 nm excimer laser for vitiligo is safe and effective.