Q-开关激光对黄褐斑动物模型黑素细胞病理形态的影响

目的:探讨Q-开光1064nm Nd:YAG激光不同能量照射对黄褐斑动物模型表皮黑素细胞病理形态的影响。方法:用Q-开关1064nm Nd:YAG激光不同能量和频率照射黄褐斑动物模型背部皮肤,分别于激光照射前和照射后不同阶段取材,通过HMB45免疫组化染色法,光镜观察豚鼠表皮黑素细胞的变化。结果:第一次激光照射后即刻可见高能量两组黑素阳性细胞减少,第5次激光照射后即刻可见低能高频组黑素阳性细胞减少。与术前比较,低能量密度低频率照射组黑素细胞阳性细胞数无显著差异。5次治疗后软件分析结果显示,高能高频、高能低频和低能高频组与照射前比较黑素细胞阳性目标个数、平均数密度、平均光密度下降,但平均灰度值上升,差异有统计学意义(P<0.01)。结论:高能量密度Q-开光Nd:YAG激光照射对表皮黑素细胞的影响大于低能量密度,当其超过一定阈值时能高能量高频率可导致黑素细胞的损伤和减少。从而为临床应用Q-开关1064nm Nd:YAG激光治疗色素性疾病提供了实验依据。     

Q-开关激光对黄褐斑动物模型黑素细胞黑素合成的影响

目的：观察Q开关激光不同能量照射对黄褐斑动物模型黑素细胞的增殖、黑素生成及酪氨酸酶活性的影响。方法：用Q开关激光不同能量照射黄褐斑动物模型,取表皮黑素细胞进行细胞培养,采用MTT法测定细胞活力的影响;氢氧化钠裂解法测定黑素的含量;体外多巴氧化反应法测定酪氨酸活性的变化;光学显微镜观察细胞形态学变化。结果：除高能高频组外各能量密度和频率组激光照射后即刻黑素细胞形态无明显变化。第5次治疗后高能量密度照射组明显可见黑素细胞数目减少、体积变小、树突数量减少,长度缩短。而低能量高频率照射组仅黑素细胞体积变小,树突数量减少,长度缩短。与术前比较,低能量低频率照射组黑素细胞增殖、黑素含量、酪氨酸活性无显著差异,但其他三组显著性下降。然而,3周术后黑素细胞增殖、黑素含量、酪氨酸活性增强趋势,有显著性意义（P〈0．05）。结论：当激光能量和频率达到一定阈值时能抑制黑素细胞的合成和酪氨酸活性,而这种损伤在一定范围内是可逆性的。从而为临床应用Q开关Nd：YAG 1064nm激光治疗色素性疾病提供了实验依据。     

1064nm Q-switched Nd：YAG激光照射对表皮黑素细胞生物效应的影响

目的：探讨Q-switched Nd：YAG激光对培养状态下的人表皮黑素细胞生物效应的影响。方法：体外培养人表皮黑素细胞,用1064nmQ-switched Nd：YAG激光,光斑直径6mm,频率2HZ,分别用低能量密度与高能量密度进行照射。光学显微镜观察黑素细胞形态学变化,MTT法检测照射后0、24h、48h、72h细胞增殖活性,流式细胞仪检测照射24h后细胞周期与凋亡。结果：各能量密度组激光照射后即刻黑素细胞形态无明显改变,但24h后高能量密度照射组黑素细胞体积变小,树突数量减少,长度缩短。与对照组比较,低能量密度照射组黑素细胞增殖无显著差异,而高能量密度照射组显著降低,并在48h内逐渐下降至最低点,随后又呈明显上升趋势。与对照组相比较,低能量密度照射组S期细胞比率轻度增加,而细胞凋亡率无明显变化。高能量密度照射组S期细胞比率减少,凋亡率显著增加。结论：高能量密度Q-switchedNd：YAG激光照射对表皮黑素细胞的影响大于低能量密度,当其达到一定阈值时能抑制黑素细胞的增殖,并促进其凋亡。而这种损伤在一定范围内是可逆性的,黑素细胞会随着时间的延长进行自我修复。低能量密度激光照射对黑素细胞生物学活性的影响...     

Q-开关Nd:YAG 1064nm激光联合谷胱甘肽凝胶治疗黄褐斑的疗效观察

目的:评估Q-开关Nd:YAG 1 064nm激光联合谷胱甘肽凝胶对黄褐斑的治疗效果。方法:选26例黄褐斑患者,随机分为两组。治疗组13例,接受Q-开关Nd:YAG激光联合谷胱甘肽凝胶治疗;对照组13例,仅采用Q-开关Nd:YAG激光治疗,每14天治疗1次,6~10次为1个疗程,疗程结束后判断疗效。结果:治疗组有效率为100%,对照组为84.6%,两组疗效比较有统计学意义(P0.05)。结论:临床对比观察Q-开关Nd:YAG 1 064nm激光联合谷胱甘肽凝胶治疗黄褐斑较单用Q-开关Nd:YAG 1 064nm激光治疗有明显优势,适合推广应用。     

Q-开关Nd:YAG激光1064nm联合还原型谷胱甘肽治疗黄褐斑的临床疗效分析

目的:探讨Q-开关Nd:YAG激光1 064nm联合还原型谷胱甘肽治疗黄褐斑的临床疗效。方法:选取黄褐斑患者62例。将患者随机分为治疗组及对照组各31例。对照组单纯应用Q-开关Nd:YAG激光1 064nm治疗;治疗组在应用Q-开关Nd:YAG激光1064nm治疗的同时联合应用还原型谷胱甘肽(GSH)0.9g,加入生理盐水250ml静滴,每日1次,每次激光治疗后连续点滴5日。结果:治疗组基本治愈12例,显效16例,好转3例,无效0例,总有效率为90.3%,对照组基本治愈9例、显效13例、好转7例、无效2例,总有效率70.9%,两组疗效比较(P0.05),差异有统计学意义。结论:Q-开关Nd:YAG激光1 064nm联合还原型谷胱甘肽治疗黄褐斑疗效确切,安全性高,无明显副作用,是一种安全、有效的治疗方法。     

低能量Q开关Nd:YAG激光对黄褐斑体表温度与黑素指数的影响

目的:观察Q开关Nd:YAG激光治疗黄褐斑时皮肤体表的温度变化,探讨体表温度的改变与黑素指数的关系。方法:对22例黄褐斑患者使用Q开关Nd:YAG1064nm激光治疗,光斑直径6mm或8mm,能量密度2.0～3.3J/cm2,每周1次,12次为1个疗程。单次激光治疗前、治疗中、治疗后即刻用红外测温仪测量黄褐斑部位皮肤体表温度,并在治疗前、治疗6次、12次后使用皮肤多功能测试仪检测相应固定部位黑素指数。结果:黄褐斑皮损区单次治疗后双面颊体表温度高于治疗前,但与正常皮肤相比无差异;激光治疗6次、12次后黑素指数均显著性减少。结论:低能量Q开关Nd:YAG激光治疗黄褐斑后皮肤温度有一定程度升高,但并不引起明显光斑反应,治疗后黑素指数降低,表明温度并非导致激光光斑反应的唯一及主要因素,可能与Q开关激光激活黑素细胞内部的反应原件相关。     

Q-开关Nd∶YAG激光联合强脉冲光治疗黄褐斑疗效分析

目的:探讨和评价Q-开关Nd:YAG激光联合强脉冲光(IPL)治疗黄褐斑的疗效和安全性。方法:将患者随机分为三组:Q-开关激光与强脉冲光联合治疗组:40例,先用Q-开关Nd:YAG激光治疗3次,再用强脉冲光治疗3次,间隔时间2个月;Q-开关激光治疗组:32例,采用Q-开关Nd:YAG(1064nm)激光治疗3次,间隔时间2个月;对照组:14例,采用中药祛斑面膜治疗,每周1次,连续4周1个疗程,总共完成6个疗程。所有患者治疗后防晒。结果:Q-开关激光与强脉冲光联合治疗组:治愈9例(22.50%),显效18例(45.0%),总有效率为67.50%;Q-开关激光治疗组:治愈4例(12.50%),显效13例(40.62%),总有效率为53.12%;对照组:治愈0例,显效2例(14.29%),总有效率为14.29%;Q-开关激光组与联合治疗组都取得了显著的疗效。联合治疗组色素沉着2例(5.0%),无增生性瘢痕;激光治疗组色素沉着3例(9.38%);对照组皮肤过敏1例(7.14%)。结论:Q-开关Nd:YAG激光联合强脉冲光(IPL)治疗黄褐斑安全、有效、副作用少,值得推广使用。     

Q-开关Nd:YAG激光治疗外源性皮肤色素性病变124例

目的：观察Q-开关Nd：YAG激光治疗外源性皮肤色素性病变的临床效果。方法：用Q-开关Nd：YAG激光1064nm波长治疗黑色、灰色或蓝色皮肤色素性病变；532nm波长治疗红色色素性病变，共计124例。结果：此方法可明显去除外源性皮肤色素性病变，效果好、无瘢痕产生，但需多次治疗。结论：Q-开关Nd：YAG激光治疗外源性皮肤色素性病变安全有效。     

Q开关激光治疗双侧面部获得性太田痣样斑287例疗效分析

目的：比较Q开关紫翠宝石755nm激光、Nd：YAG1064nm激光和倍频Nd：YAG532nm激光对双侧获得性太田痣样斑的治疗效果和副作用。方法：运用Q开关紫翠宝石755nm激光、Nd：YAG1064nm激光和倍频Nd：YAG532nm激光分别对287例患者进行治疗。结果：经过1～13次治疗后,痊愈140例,显效66例,有效59例,无效22例,总有效率71.8%,总治愈率48.8%。倍频Nd：YAG532nm激光治疗起效快而副反应明显,Q开关紫翠宝石755nm激光和Nd：YAG1064nm激光起效慢但副反应轻微。结论：三种Q开关激光均能有效治疗双侧获得性太田痣样斑,长程低能量的Q开关紫翠宝石755nm激光和Nd：YAG1064nm激光因副反应轻微更适合美容患者的需要。     

Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗黄褐斑疗效观察

目的:观察Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗黄褐斑的临床疗效。方法:2011年7月～2012年10月,选取门诊就诊的黄褐斑患者30例,随机分为治疗组和对照组,每组各15例。治疗组:接受Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗;对照组:仅接受Q开关Nd:YAG激光治疗。每次治疗后都辅以维C导入及胶原蛋白修复面膜外敷,每2周治疗1次,10次为1个疗程;治疗组同时口服氨甲环酸片,每日2次,每次250mg,连服半年。1个疗程结束即评判疗效,治疗期间及1个疗程结束后3个月观察疗效及不良反应。结果:治疗组总有效率为93.3%,对照组为73.4%,两组疗效比较,差异均有统计学意义(P<0.05),未见明显不良反应。结论:Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗黄褐斑优于单用Q开关Nd:YAG激光治疗,且不良反应少,适合临床应用。     

Clinical,histologic, and ultrastructural evaluation of tattoos treated with three laser systems

We examined the response of tattoo pigments treated with three commercially available lasers: Q-switched ruby, Q-Switched neodynium:yttrium, aluminum, garnet (Nd:YAG), and the alexandrite. Tattoos applied to hairless guinea pigs and treated with the aforementioned lasers were evaluated clinically, histologically, and ultrastructurally. Clinical evaluation showed red brown, dark brown, and orange pigment responded best to the Nd:YAG laser (1064 nm). The alexandrite laser was most effective for removing blue and green pigment, the Q-switched ruby laser was most effective for removing purple and violet pigment, and the NdYAG laser (532 nm) removed red pigment the best. Black pig ment was lightened equally with the Nd:YAG laser (1064 nm) and (532 nm) and the alexandrite laser (755 nm). No clinical scarring was observed; however, some colors turned black after treatment. Histologic and ultrastructural examination showed epidermal and dermal damage to be most evident after treatment with the Nd:YAG laser. Our study shows that certain tattoo pigments respond better to different laser systems. © 1994 WiIey-Liss, Inc.     

单用强脉冲光、长脉宽Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效比较

目的:观察单用强脉冲光、长脉宽1064nm Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效和不良反应。方法:联合应用590～1200nm强脉冲光(能量密度12～16J/cm2,脉宽3.0～5.0ms)以及长脉宽1064nm Nd:YAG激光(能量密度80～90J/cm2,脉宽10～20ms)治疗51例微静脉畸形患者;并与单独应用强脉冲光(能量密度13～20J/cm2)及长脉宽Nd:YAG激光(能量密度120～145J/cm2)治疗结果比较。结果:强脉冲光、长脉宽1064nmNd:YAG激光及低能量下联合使用治疗微静脉畸形的有效率分别为33.1%、40.3%和56.9%,瘢痕发生率分别为0%、10.7%和5.9%。结论:低能量下联合使用强脉冲光及长脉宽1064nm Nd:YAG激光提高了微静脉畸形的有效率,且不良反应小。     

调Q开关Nd：YAG激光治疗165例颧部褐青色痣疗效观察

目的：观察调Q开关Nd：YAG激光治疗颧部褐青色痣的临床疗效和安全性。方法：应用Q开关Nd：YAG激光治疗颧部褐青色痣患者165例,选用波长1064nm,能量密度4.5～6.0J/cm2,光斑直径3mm,频率1～10Hz;532nm波长能量密度为1.8～2.2J/cm2,光斑直径3mm,频率1～10Hz,共治疗2～5次,术后3个月复诊判定疗效和不良反应。结果：共治愈45例,平均治疗2.6次,总有效率74.1%。术后发生色素沉着89例,无瘢痕发生。结论：调Q开关Nd：YAG激光治疗颧部褐青色痣疗效好,安全性高,不良反应较轻。     

An In Vivo Trial Comparing the Clinical Efficacy and Complications of Q-Switched 755 nm Alexandrite and Q-Switched 1064 nm Nd:YAG Lasers in the Treatment of Nevus of Ota

BACKGROUND: Q-switched 755 nm alexandrite (QS alex) and Q-switched 1064 nm Nd:YAG lasers are effective in the treatment of nevus of Ota. Our previous in vivo study indicated that patients better tolerate QS alex than QS 1064 nm Nd:YAG laser. However, in terms of clinical efficacy and long-term complications, the study did not indicate which laser is superior. Although both machines may appear to be similar in effectiveness, the low number of treatment sessions may contribute to this apparent lack of difference. OBJECTIVE: The aim of this study was to compare the clinical efficacy and complications of QS 755 nm alex and QS 1064 nm Nd:YAG lasers in the treatment of nevus of Ota after three or more treatment sessions. METHOD: Forty patients were recruited for this study and all had received three or more laser treatment sessions with an interval of at least 2 months between each. Half of the lesion was treated with QS alex and the other half with QS 1064 nm Nd:YAG laser. The degree of lightening was assessed subjectively by the patient using a visual analog scale and objectively by two independent clinicians. Patients were called back to be examined for evidence of complications. RESULTS: In terms of subjective degree of lightening, QS 1064 nm Nd:YAG laser was found to be significantly more efficacious than QS alex (P = 0.018). Both clinicians also found QS 1064 nm Nd:YAG laser to be more effective, but statistical significance was only detected in one, not both of their scores (P = 0.005 and 0.414 for observers 1 and 2, respectively). More patients that received QS Alex developed complications (4 for QS alex and 2 for QS Nd:YAG), but the difference was not statistically significant. CONCLUSION: QS 1064 nm Nd:YAG laser appears to be more effective than QS alex in the lightening of nevus of Ota after three or more laser treatment sessions. However, the majority (55%) of the patients reported no differences in results between the two lasers, and only one of the two observers noted statistically significant improvement of QS 1064 nm Nd:YAG over QS alex.