组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2015, Vol. 11 ›› Issue (1): 37-40.doi: 10.3969/j.issn.1673-0364.2015.01.012

• 论著 • 上一篇    下一篇

面部不同亚解剖区域葡萄酒色斑激光治疗效果差异的病理学基础

于文心，马刚，仇雅璟，陈辉，金云波，杨希，胡晓洁，王天佑，常雷，李伟，周恒花，林晓曦   

  1. 上海交通大学医学院附属第九人民医院整复外科；上海交通大学医学院附属第九人民医院病理科
  • 发布日期:2020-07-23

Histopathological Basis of Different Anatomic Subunit of Facial Port-Wine Stain Treated by Pulsed Dye Laser

YU Wenxin,MA Gang,QIU Yajing,CHEN Hui,JIN Yunbo,YANG Xi,HU Xiaojie,WANG Tianyou,CHANG Lei,LI Wei,ZHOU Henghua,LIN Xiaoxi   

  1. Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine; Department of Pathology,Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine;
  • Published:2020-07-23
  • Contact: 上海市卫生系统重要疾病联合攻关重点项目(2013ZYJB0014)

摘要： 目的探讨面部不同亚解剖区域葡萄酒色斑(Port-wine stain,PWS)脉冲染料激光(Pulsed dye laser,PDL)治疗效果差异的病理学基础。方法 6例患者按面部不同亚解剖区域(A、B区)行PWS的病理活检,对PWS血管的管径及深度进行测量,并给予脉冲染料激光治疗。术后2个月光度计测量(ΔE和Δa*值),进行疗效评估,并对各区域结果进行比较分析。结果患者均接受脉冲染料激光治疗,光度计测量示B区PWS的平均Δa*和ΔE值分别为(4.63±2.24)及(8.81±2.24),而A区PWS的平均Δa*及ΔE值分别为(-0.19±2.40)及(3.55±1.46),两者差异显著(P<0.05)。组织学表现示B区PWS扩张的血管主要分布于真皮浅层,而A区PWS扩张的血管分布于真皮浅层至深层,部分累及皮下。皮尔森相关系数显示PWS血管深度、血管管径与PDL疗效呈负相关。结论对同一位患者,相比于面部偏中心区域PWS,PDL对偏外周区域PWS具有更佳疗效;PWS血管的组织学差异特别是血管深度,可能是面部不同亚解剖区域PWS疗效差异的重要原因之一。

关键词: 亚解剖区域, 葡萄酒色斑, 脉冲染料激光, 疗效差异, 病理学

Abstract: Objective To explore the histopathological basis of different anatomic subunit of facial port-wine stain (PWS) treated by pulsed dye laser (PDL) and to illustrate the possible explanation for the discrepancy of therapeutic efficacy. Meth-ods Six PWS patients had biopsies and underwent PDL treatments in different anatomic subunit of facial PWS (A and B area). The diameter and depth of PWS vessels were analyzed and the clinical efficacy were evaluated by chromameter assess-ment 2 months after treatment. Results All patients were treated on both sites, according to the chromameter evaluation, av-erageΔa*and averageΔE were 4.63±2.24 and 8.81±2.24 for B area, while-0.19±2.40 and 3.55±1.46 for A area respective-ly (P<0.05). Histopthological observation showed that ectatic vessels in B area were primarily distributed in super dermis, while the ectatic vessels in A area were distributed extensively from capillaries to the reticular dermis, and even deep into the subcutaneous tissue. The Pearson correlation coefficient suggested that the depth and diameter of PWS vessels were negative-ly related to efficacy outcomes of PDL treatment. Conclusion Better results can be obtained in lateral facial PWS compared to central facial PWS on the same patient. The differences in histopathological manifestation, especially the depth of vessels, may be responsible for the discrepancy of therapeutic efficacy.

Key words: Anatomic subunit, Port-wine stain, Pulsed dye laser, discrepancy of therapeutic efficacy, Pathology

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