AOPT-LTL模式强脉冲光治疗玫瑰痤疮的疗效观察

Observation on the Efficacy of AOPT-LTL Mode Intense Pulsed Light in the Treatment of Rosacea

目的评估优化脉冲技术(OPT)的新治疗模式(即超光子-应用低能量、三脉冲、长脉宽AOPT-LTL)治疗红斑毛细血管扩张型玫瑰痤疮(ETR)的安全性和有效性。并观察AOPT-LTL模式在玫瑰痤疮样小鼠模型中的治疗效果,分析相关作用机制。方法将16例ETR患者纳入研究,采用AOPT-LTL模式进行治疗,选择590/640 nm滤光片,能量密度10~16 J/cm^(2),三脉冲输出模式,脉冲宽度分别为8 ms、6 ms和6 ms,脉冲延迟35~40 ms,治疗间隔为2周。在治疗前后应用VISIA皮肤检测仪和皮肤镜获取临床照片以评估疗效。同时用LL-37构建玫瑰痤疮样小鼠模型,观察AOPT-LTL治疗后皮损的改善情况。HE染色观察组织学变化并计算炎性细胞数目。免疫组织化学染色观察玫瑰痤疮相关炎性因子(TLR2、Camp、IL-6和MMP-1)的表达情况。结果AOPT-LTL治疗后患者病情均得到不同程度的改善,治疗有效率达81.25%。治疗期间,患者均未发生明显的不良反应。在动物实验中,AOPT-LTL治疗后小鼠玫瑰痤疮样皮损得到显著改善,炎性细胞数目显著下降(P<0.01),玫瑰痤疮相关炎性因子的表达均显著降低(P<0.01)。结论AOPT-LTL是一种治疗玫瑰痤疮安全且有效的方法。

Objective To evaluate the safety and efficacy of a new treatment mode of optimized pulse technique(OPT),namely advanced optimized pulse technique with low energy,three pulses,and long pulse width(AOPT-LTL)in the treatment of erythematotelangiectatic rosacea(ETR).The therapeutic effect of AOPT-LTL mode in rosacea-like mouse model was observed and the related mechanism was analyzed.Methods Sixteen patients with ETR were enrolled in the study and treated with AOPT-LTL mode,590/640 nm filter was selected,energy density was 10-16 J/cm^(2),three-pulse output modes with pulse widths of 8 ms,6 ms,and 6 ms,pulse delay was 35-40 ms,treatment interval was 2 weeks.Before and after treatment,VISIA skin image analyzer and dermoscopy were used to obtain clinical photographs to evaluate the curative effect.In addition,we used LL-37 to establish a rosacea-like mouse model to observe the improvement of skin lesions after AOPT-LTL treatment.The histological changes were observed by HE staining and the number of inflammatory cells was calculated.Immunohistochemical staining was used to observe the expression of inflammatory factors(TLR2,Camp,IL-6 and MMP-1)associated with rosacea.Results After AOPT-LTL treatment,the condition of all patients was improved in varying degrees,and the effective rate of treatment was 81.25%.During the treatment,no serious adverse events were observed.In animal experiment,the rosacea-like lesions of mice treated with AOPT-LTL were significantly improved,the number of inflammatory cells and the expression of inflammatory factors related to rosacea were significantly decreased(P<0.01).Conclusion AOPT-LTL is a safe and effective method to treat ETR.