寻常疣脉冲染料激光治疗前后激光散斑成像观察

摘要/Abstract

摘要： 目的采用激光散斑衬比分析（LSCA）技术无创性观察分析不同部位和大小的疣体激光治疗前后的血流变化，以探讨LSCA技术用于激光治疗寻常疣疗效量化评价的可能性。方法采用脉冲染料激光（PDL）治疗17例寻常疣患者30处病灶，使用LSCA观察和记录治疗前、治疗后10 min、治疗后3周疣体及其周围正常皮肤血流变化及散斑流速指数（SFI）值，以评估PDL治疗的效果。结果寻常疣患者治疗前疣体的血流SFI值（11.600 ± 1.190）高于周围正常皮肤（5.280 ± 0.481），差异有统计学意义（t = 8.169，P < 0.01）。与治疗前疣体SFI值相比，治疗后10 min（3.112 ± 0.484）和治疗后3周时（7.315 ± 1.083）疣体血流SFI值均显著降低（t值分别为4.407、3.294，均P < 0.01），治疗后3周高于治疗后10 min（t = 4.646，P < 0.01）。激光治疗后10 min疣体周围正常皮肤血流SFI值（20.260 ± 2.063）较治疗前显著升高（t = 6.770，P < 0.01），但治疗后3周（4.941 ± 0.616）又较治疗后10 min显著降低（t = 6.964，P < 0.01），治疗后3周与治疗前相比，差异无统计学意义（t = 0.378，P = 0.707）。激光治疗的效果与疣体大小和分布部位有关， < 0.5 cm2疣体激光治疗后血流改变较 ≥ 0.5 cm2疣体更大，差异有统计学意义（t = 2.287，P < 0.05）；不同分布部位的疣体激光治疗后血流改变不同（F = 15.71，P < 0.01），不同部位疣体血流SFI值改变由大到小依次为手指、足背、足趾、掌跖、甲周。结论寻常疣疣体内血流较正常皮肤明显升高，PDL可以凝固气化疣体内血管达到治疗目的。利用LSCA血流监测技术，能定量观察到激光治疗寻常疣前后的血流变化。

Abstract: Wu Xixi, Feng Aiping Laser Room, Department of Plastic Surgery, Wuhan Third Hospital, Wuhan 430060, China; Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022，China （Feng AP） Corresponding author: Feng Aiping, Email: xunxicici@163.com 【Abstract】 Objective To visualize blood flow changes in verruca vulgaris noninvasively with laser speckle contrast analysis （LSCA）, and to evaluate the relationship of size and location of warts with efficacy of laser treatment. Methods Pulsed dye laser （PDL） was used to treat 30 verruca vulgaris lesions in 17 patients. In order to evaluate therapeutic effect of PDL, LSCA was performed to observe blood flow in warts and their surrounding normal skin, and to calculate speckle flow index （SFI） values before laser treatment, and at 10 minutes as well as on 3 weeks after laser treatment. Results Before PDL treatment, SFI values were significantly higher in warts than in their surrounding normal skin （11.600 ± 1.190 vs. 5.280 ± 0.481, t = 8.169, P < 0.01）. Compared with those before the treatment, SFI values in warts significantly decreased at 10 minutes （3.112 ± 0.484, t = 4.407, P < 0.01） and on week 3 （7.315 ± 1.083, t = 3.294, P < 0.01） after the treatment, and were significantly higher on week 3 than at 10 minutes （t = 4.646, P < 0.01）. SFI values in surrounding normal skin significantly increased at 10 minutes after the treatment compared with those before the treatment （20.260 ± 2.063 vs. 5.296 ± 0.708, t = 6.770, P < 0.01）, but were significantly lower on week 3 than at 10 minutes （4.941 ± 0.616, t = 6.964, P < 0.01）. No significant difference was observed between SFI values in surrounding normal skin on week 3 after the treatment and those before the treatment （t = 0.378, P = 0.707）. The efficacy of laser treatment was associated wart size and location. Changes of blood flow （|ΔSFI|） were significantly higher in warts measuring less than 0.5 cm2 in size than in those equal to or more than 0.5 cm2 （t = 2.287, P < 0.05）, and significantly differed among warts at different sites （F = 15.71, P < 0.01）. The greatest changes of blood flow in warts were observed on fingers, followed by the dorsum of feet, toes, palms and soles and periungual areas. Conclusions Blood flow in verruca vulgaris is markedly increased compared with that in normal skin. PDL can clear verruca vulgaris by solidifying and gasifying capillaries. LSCA may be used to evaluate the efficacy of laser on verruca vulgaris more quantitively by monitoring regional blood flow.

吴希晞冯爱平. 寻常疣脉冲染料激光治疗前后激光散斑成像观察[J]. 中华皮肤科杂志, 2016, 49(3): 183-186.doi:

Wu Xixi. Observation of blood flow in verruca vulgaris using laser speckle contrast imaging before and after pulsed dye laser treatment[J]. Chinese Journal of Dermatology, 2016, 49(3): 183-186.doi:

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