中波高能紫外线与308 nm准分子激光治疗白癜风的短期疗效比较

【摘要】 目的 比较中波高能紫外线和308 nm准分子激光治疗白癜风的短期疗效。 方法 中波高能紫外线组患者40例,每周照射2次;308 nm准分子激光组40例,每周1次。评估两组治疗8周后的皮损复色情况。 结果 经过8周的阶段治疗,中波高能紫外线组有83.6%皮损可出现不同程度的复色反应,达显效以上复色为42.1%;308 nm准分子激光组86.1%有皮损不同程度色素生成,达到显效以上为50%。对于面部白癜风皮损中波高能紫外线的疗效低于308 nm准分子激光（χ2 = 4.32,P < 0. 05）,在其余部位两组有效率差异无统计学意义。在皮损起始复色的累积剂量方面,两者差异无统计学意义（t = 0.89,P > 0.05）,在达到显效以上复色方面,高能中波紫外线的治疗次数和累积剂量明显多于308 nm准分子激光（P < 0. 01）。两者均适用于儿童患者及活动期皮损。 结论 中波高能紫外线或308 nm准分子激光治疗白癜风均可在短期内起效且安全,308 nm准分子激光疗效更明显。     

308nm准分子激光与窄谱中波紫外线治疗局限性白癜风疗效比较

308nm准分子激光与窄谱中波紫外线(NB-UVB)近年来在临床广泛用于治疗白癜风,已成为白癜风有效、简单、安全的治疗方法,我科于2009年2月—2010年5月对二者治疗寻常型局限性白癜风的疗效进行了比较,结果报道如下。1资料与方法1.1临床资料90例稳定期寻常型局限性白癜风患者,男     

308nm准分子激光治疗白癜风进展

由氯化氙准分子激光器发出的308nm准分子激光,具有选择性作用于病变皮损、方便、高效、不良反应小的特点,近来在白癜风治疗中取得了显著效果,并为较多的患者所接受,本文简单综述该激光在白癜风治疗中的应用进展。     

308nm准分子激光联合胡椒碱治疗白癜风疗效观察

目的评价308nm准分子激光联合胡椒碱对白癜风的临床疗效和安全性。方法将入选的87例白癜风患者按就诊顺序随机分为2组,共80例患者完成试验观察,治疗组予308nm准分子激光局部照射每周2次,联合胡椒碱酊局部外用2次/d治疗,对照组予308nm准分子激光局部照射每周2次,联合8-甲氧基补骨脂素(8-MOP)溶液局部外用2次/d治疗。治疗时间为4周一疗程,治疗3个疗程,比较2组患者在白癜风皮损复色上的差异。结果治疗组的显效率90%,对照组为77.5%。2组显效率差异有统计学意义(P0.05),治疗中未出现严重的不良反应。结论 308nm准分子激光联合胡椒碱对于治疗白癜风有明显的效果,且无明显不良反应,对白癜风的治疗是一个很好的选择。     

308 nm准分子激光治疗白癜风的临床疗效观察

应用临床分组比较的开放性研究方法,选择216例白癜风患者403处皮损,给予308 nm准分子激光局部照射,每周2～3次,10次为一疗程,所选患者均完成二个疗程治疗,并随访3个月以上.＜14岁组和≥14岁组治疗有效率分别为62.82%、68.62%,两组比较无统计学差异(P＞0.05);不同部位皮损的疗效显示,面颈部疗效最好,躯干、四肢次之,肢端疗效最差,各组之间比较差异有统计学意义(P＜0.05).308 nm准分子激光治疗白癜风起效快、疗效好,不良反应少,不同部位对疗效有一定的影响,患者年龄不是影响疗效的主要因素.     

308nm准分子激光治疗白癜风概述

白癜风治疗方法较多,308 nm准分子激光凭借起效快、疗效高及副作用小等优势而迅速应用于临床。其治疗白癜风的作用机制不清,可能通过诱导皮损处浸润的淋巴细胞凋亡而取得疗效。联合外用他克莫司软膏或吡美莫司乳膏治疗白癜风效果比单独应用308 nm准分子激光更为显著。     

308nm准分子光治疗白癜风疗效评价

目的：评价308nm准分子紫外光治疗白癜风的临床疗效。方法：31例进展期和34例稳定期白癜风患者皮损行308nm准分子紫外光治疗,共照射30次。结果：进展期和稳定期白癜风患者总有效率分别为62．14％、73．52％,无显著性差异（P〉0．05）。头面部及躯干部效果较好,肢端效果最差。结论：308nm准分子紫外光治疗白癜风安全有效,其疗效与皮损部位相关,与进展期或稳定期无关。     

308 nm准分子激光治疗白癜风的研究进展

白癜风是一种难治的疾病。随着308 nm准分子激光作为一种新型光源在治疗银屑病中取得显著成效,也渐渐被用来治疗白癜风,且已得到患者及临床医师的认可。本文对308 nm准分子激光治疗白癜风的研究进展综述如下。     

308nm准分子激光治疗儿童白癜风疗效观察

目的评价308nm准分子激光治疗儿童白癜风的疗效及安全性。方法采用自身对照的方法,用Xt-rac颠峰准分子激光系统治疗85例稳定期儿童白癜风患者(年龄≤12岁)的自身对称或相邻皮损,每周治疗1～3次,共30次,每隔10天及治疗结束3天后评价疗效。结果治疗的皮损痊愈12例,显效45例,好转21例,无效7例,显效率为67.1%,有效率为91.8%;未治疗的皮损仍为色素脱失斑。面颈部疗效优于躯干四肢,躯干四肢优于肢端,面颈部非节段型优于节段型。结论308nm准分子激光治疗稳定期儿童白癜风疗效高、副作用少,其疗效与皮损部位有关。     

308 nm准分子激光治疗白癜风临床疗效观察

目的：观察308nm氯化氙准分子激光治疗白癜风的临床疗效及不良反应。方法：采用Xtrac颠峰准分子激光系统对77例白癜风患者不同部位共292处皮损进行治疗,每周1～2次。并观察疗效,达到3级色素恢复后对相关因素进行分析。结果：经治疗面颈部皮损起效最快,其次为躯干部、四肢,褶皱部最慢;年龄〈18岁患者皮损起效快于年龄〉18岁患者;不同性别、疾病分期、病程、皮肤类型患者的起效快慢差异无统计学意义。结论：308nm准分子激光治疗白癜风疗效好,不良反应少,其疗效与年龄、皮损部位有关。     

308 nm SQ LED光与308 nm准分子光治疗面部白癜风的疗效及安全性回顾性研究

目的:比较308 nm SQ LED光与308 nm准分子光治疗面部白癜风的治疗效果及安全性。方法:回顾分析2018年6月至2020年6月就诊于中国医学科学院皮肤病医院理疗科采用308 nm SQ LED光（LED组）或308 nm准分子光（准分子光组）治疗的稳定期面部白癜风患者。每周治疗1次或2次,纳入治疗8次以上的...     

单频准分子光治疗白癜风的临床研究

目的 研究观察单频准分子光308nm局部照射治疗白癜风的临床疗效,评估其安全性.方法 对77例不同临床类型的白癜风患者的201处皮损进行局部照射,每周1次,随访3-6个月.结果 经过准分子光局部照射平均18次,86.6%皮损有不同程度色素恢复,色素恢复随疗程延长而增加,照射24次总有效率为71.0%,显效率为51.6%.躯干、颈部和头面部疗效优于四肢及手足;泛发型和节段型白癜风疗效尤佳.主要不良反应为局部水疱和疼痛,患者能耐受.结论 准分子光局部照射治疗白癜风疗效显著,且不良反应少.     

308nm准分子激光治疗白癜风的疗效

目的 探讨308 nm准分子激光治疗白癜风的疗效及其不同年龄、不同部位和不同病程患者疗效的差异,以及疗效与疗程之间的关系.方法 应用临床分组比较的开放性研究方法,选择稳定期白癜风患者360例,≥14岁及<14岁者皮损各180处,给予308nm准分子激光局部照射,每周2次共10周(20次),并随访3个月.结果 ≥14岁组和<14岁组治疗总有效率分别为62.2%和63.3%,显效率分别为34.4%和44.4%,两组比较差异无统计学意义(P>0.05);不同部位皮损的疗效显示,面颈部疗效最好,躯干四肢部疗效次之,肢端关节部疗效最差,差异有统计学意义(P均<0.05);不同病程的皮损疗效亦不相同,病程越短疗效越好,适当延长疗程可提高疗效.结论 308 nm准分子激光治疗稳定期白癜风疗效好,起效快,不良反应少,患者的年龄差别对疗效的影响不明显,而皮损的部位、病程和治疗次数对疗效有一定的影响.     

Optimal weekly frequency of 308-nm excimer laser treatment in vitiligo patients

BACKGROUND: Recently the beneficial effect of excimer laser treatment has been reported for patients with vitiligo. The influence of treatment frequency on this effect is not clear. OBJECTIVES: To determine the optimal frequency of 308-nm excimer laser therapy for vitiligo. METHODS: In this prospective, university-based hospital study over 12 weeks we enrolled 14 patients. Each had at least three stable vitiligo lesions in the same body area. The three stable vitiligo lesions in each subject were randomly assigned to receive excimer laser treatment once (1 x), twice (2 x) and three times (3 x) weekly, respectively. The initial ultraviolet (UV) dose was 50 mJ cm(-2) less than the 308-nm minimal erythematous dose in vitiligo skin. The UV dose was increased at each treatment session according to the erythematous response to the previous treatment. RESULTS: Thirteen subjects were treated for at least 6 weeks; seven were treated for all 12 weeks. At 6 weeks, the repigmentation rates for treated lesions were 8% (1/13) after 1 x weekly treatment, 23% (3/13) after 2 x weekly treatment and 62% (8/13) after 3 x weekly treatment (P = 0.0134; 3 x vs. 1 x weekly); at 12 weeks, these rates were 46% (6/13), 62% (8/13) and 69% (9/13), respectively (P = NS; 3 x vs. 1 x weekly). Repigmentation initiation correlated with treatment number, regardless of frequency (P = NS). As shown by Kaplan-Meier analysis, repigmentation occurred earliest in the most frequently treated lesions (P = 0.0336). At 12 weeks, the projected repigmentation rates for 1 x, 2 x and 3 x weekly treatment approached each other (60%, 79% and 82%, respectively); the mean repigmentation grades (on a scale of 0-5) for 1 x, 2 x and 3 x weekly treatment were 1.7, 2.4 and 3.3, respectively (P = 0.018; 3 x vs. 1 x weekly). Laser-induced repigmentation persisted in most cases over the entire follow-up of 12 months after the end of treatment. CONCLUSIONS: 308-nm excimer laser therapy is effective against vitiligo. Although repigmentation occurs fastest with 3 x weekly treatment, the ultimate repigmentation initiation seems to depend entirely on the total number of treatments, not their frequency. However, treatment periods of more than 12 weeks may be necessary to obtain a satisfactory clinical repigmentation, particularly when vitiligo lesions are treated only 1 x or 2 x compared with 3 x weekly.     

308-nm excimer laser for the treatment of localized vitiligo

BACKGROUND AND OBJECTIVE: Vitiligo is commonly treated with PUVA, and more recently, narrow-band UVB (NBUVB) phototherapy. Given the proximity of the wavelengths of NBUVB (311 nm) and the excimer laser (308 nm), we undertook a clinical trial to test the efficacy of this device. METHODS: Twice-weekly 308-nm UV-B radiation was given to selected vitiligo lesions for a maximum of 60 treatments. These lesions had been unsuccessfully treated previously with at least one other method of treatment. Initial doses were 100 mJ/cm2 with increments of 10-25%. Improvement was assessed on a visual scale via serial photographs. RESULTS: Subjects tolerated the treatment well. Improvement varied with body site. After 60 treatments, lesions on the hands and feet showed grade 2 improvement in 2/10 subjects and grade 1 in 8/10. For the axillae, there was grade 4 improvement in 1/3 subjects and grade 2 improvement in 2/3 by treatment 60. The face demonstrated the most rapid repigmentation with grade 4 repigmentation seen in 3/5 subjects by 40 treatments and grade 3 in 2/5 by 30 treatments. There were no adverse effects. CONCLUSIONS: The user-friendly 308-nm excimer laser allows targeted treatments of localized vitiligo.     

他克莫司乳膏联合308nm高能准分子光治疗外阴白癜风30例临床疗效观察

目的：观察他克莫司乳膏联合308nm高能准分子光治疗外阴白癜风的临床疗效。方法：外阴白癜风患者60例,随机分为试验组和对照组,每组30例。试验组皮损区每天外用0.1%他克莫司乳膏2次,再给予每周2次308nm高能准分子光治疗;对照组仅给予每周2次308nm高能准分子光治疗,3个月后评价临床疗效。结果：两组有效率分别为90.0%、66.7%,差异有显著统计学意义（χ^2=4.81,P〈0.01）。结论：他克莫司软膏联合308nm高能准分子光治疗外阴白癜风可以促进皮损色素再生和扩散,是一种安全、高效的方法。     

Comparison of the 308-nm excimer laser and a 308-nm excimer lamp with 311-nm narrowband ultraviolet B in the treatment of psoriasis

BACKGROUND: Psoriasis is a chronic, genetically determined inflammatory disease, characterized by an immunomediated pathogenesis, which affects approximately 1-3% of the population. Various modalities have been used for psoriasis treatment, including ultraviolet (UV) radiation. Narrowband UVB (311 nm) phototherapy is a well-established, widely used and highly efficient treatment for psoriasis, but a big disadvantage is that large areas of unaffected skin are irradiated along with the psoriatic lesions. OBJECTIVES: This investigation evaluates a 308-nm excimer laser and a 308-nm excimer lamp in comparison with 311-nm narrowband UVB in the treatment of patch psoriasis by using two different dose-increase schemes. MATERIALS AND METHODS: Fifteen patients with plaque psoriasis were enrolled in the study (first regime). Three different psoriatic lesions were treated with the 308-nm excimer laser, the 308-nm excimer lamp or 311-nm narrowband UVB three times per week. UVB doses were increased slowly and stepwise (1, 1, 2, 2, 3, 3, ...multiple MEDs). Sixteen patients were enrolled in the second regime. Two plaques were treated with the 308-nm excimer laser or with the 308-nm lamp with an accelerated scheme (2, 2, 4, 4, 6, 6, ...multiple MEDs) three times per week. We increased the UVB doses every second treatment (first and second regime) during the whole treatment. If blistering occurred, the blistered plaque was not treated on the next scheduled treatment. At every third visit and 1, 2 and 4 months after the last treatment a Psoriasis Severity Index (PSI) score was assigned in both regimes. RESULTS: Using Friedman analysis, the PSI scores did not show a statistically significant difference (P > 0.05) comparing 308-nm laser therapy, 308-nm lamp therapy and 311-nm narrowband therapy after 10 weeks in the first regime. The mean number of treatments to achieve clearance was 24. With the accelerated scheme, clearance could be achieved with fewer treatments and with half the cumulative dose of the first regime. Nevertheless, the side-effects such as blistering and crusting were also increased. CONCLUSIONS: Both 308-nm light sources can clear patch psoriasis in a similar manner to standard phototherapy, with the advantage of the ability to treat exclusively the affected skin and with a reduced cumulative dose, thus perhaps reducing the long-term risk of carcinogenicity.     

308 nm准分子激光联合CO2点阵激光治疗稳定期白癜风的疗效观察

 目的:观察308 nm准分子激光联合CO2点阵激光对于稳定期白癜风的治疗效果及安全性。方法：选取118例稳定期白癜风患者,使用随机数字表法分为观察组和对照组,观察组59例（皮损总数328处）,对照组59例（皮损总数319处）。观察组采用308 nm准分子激光联合CO2点阵激光治疗,对照组单纯采用308 nm准分子激光治疗。治疗3个月后,比较两组疗效及不良反应发生情况。结果：治疗后,观察组及对照组总有效率分别为89.94%和84.64%,两组总有效率比较,差异有统计学意义(X²=6.59,P=0.014),两组不良反应总发生率分别为23.34%和22.15%,两组比较差异无统计学意义( X²=1.29,P=0.088)。结论：308 nm准分子激光联合CO2点阵激光对于稳定期白癜风具有良好的疗效。