激光等物理治疗对置入的聚甲基丙烯酸甲酯微球结构影响的观察

Effects of laser, radiofrequency and intensive pulse light on injectable polymethylmethacrylate （ Artecoll ）

目的 评估注射皮肤填充剂爱贝芙（Artecoll）后，再联合使用激光等其他美容手段后的有效性及安全性。方法 体外实验：直接对爱贝芙进行点阵激光照射后，观察其微球结构的完整性与表面的光滑程度等变化。动物实验：分别用猪及豚鼠建立相应的短期和中长期填充剂动物模型，并进行后续的激光、射频等治疗，光镜、电镜观察比较激光治疗前后的微球结构及组织的炎症程度变化等。结果 体外研究结果，未发现经多次激光照射后爱贝芙中的聚甲基丙烯酸甲酯（polymethyl-methacrylate，PMMA）微球的形状和结构发生变形或破坏等情况，微球表面仍光滑如初。动物实验表明，爱贝芙较长期置入动物后，PMMA微球仍能保持良好的结构和光滑的表面，未见微球被吞噬破坏。在多次激光等其他手段治疗后，微球置人部位炎症细胞浸润程度与未经激光治疗的对照组比较无差异。结论 爱贝芙是一种安全有效的永久性皮肤填充剂，临床使用某些激光、射频的治疗不会影响其安全性。

Objective To evaluate the safety and efficacy of polymethylmethacrylate/PMMA （Arteeoll） as an injectable dermal filler after using laser, radiofrequency and intensive pulse light. Methods In vitro, factional photothermolysis （Affirm） was directly used on the PMMA to see if there was any change in the structure or surface smoothness. In vivo, pig and guinea pig were used as the short-term and long-term models, respectively, for Artecoll. The dermal filler was first injected and then laser treatments conducted. The skin sample was observed through light microscope, scanning electronic microscope and transmission electronic microscope to see whether there were any structural changes, infiltration of inflammatory ceils and the regeneration of collagen. Results Through the microscopic observation of in vitro experiment and the animal models, no distortion or rupture of the microsphere were found after the laser treatment. No uneven surface was found in the PMMA microsphere either. The microshpere was surrounded by the inflammatory cells. The infiltration was mild to intermediate with few foreign body giant cells even after several treatments of laser. There was no macrophage seen. But the collagen regeneration was distinguishable after the laser treatment. No obvious structural change was found eventually. Conclusion Artecoll is a safe and effective permanent injectable dermal filler for wrinkle reduction and contour refining.