光动力疗法在脉管畸形治疗中的应用

Photodynamic Therapy for Vascular Malformations

血管靶向光动力是治疗血管性疾病的一种新手段。其作用原理是在有氧和在激发光源照射条件下,使光敏剂在血管内皮细胞内发生强烈的光动力反应,产生大量的单线态氧,选择性破坏血管内皮细胞,从而达到靶向治疗血管性疾病的目的。鲜红斑痣是最常见的血管畸形之一,世界范围新生儿的发病率为0. 3%～0. 5%。血管靶向光动力正在成为治疗鲜红斑痣的较好选择之一。我国最近上市的新型光敏剂海姆泊芬,已被证实可以更加有效的治疗鲜红斑痣。深在性血管畸形的治疗则更加困难。血管靶向光动力已经被成功用于治疗危及生命的遗传出血性毛细血管扩张症及其他深在的血管畸形病变。

Vascular targeting photodynamic therapy （V-PDT） is a new approach for management of vascular disease. In aerobic environment, V-PDT selectively damages the vascular endothelia cells via singlet oxygen generated by the light activated photosensitizers, therefore can precisely treat vascular abnormalities. Port-wine stain is the most common manifestation of vascular malformation and its occurring rate is 0.3% - 0.5% worldwide. V-PDT has come into being a good choice for management of port-wine stain. With the recently approved new photosensitizer, hemoporfin, better outcome could be achieve. The treatment of deep vascular malformation is more challenging. V-PDT has been successfully applied to management of life-threatening hereditary hemorrhagic telangiectasia and other deep vascular malformations.