血卟啉衍生物静脉注射后在皮肤中分布的实验研究

目的探讨鲜红斑痣光动力学疗法中血卟啉衍生物（ＨｐＤ）的理想剂量和理想照光时间。方法５组实验用新西兰白兔（每组６只）分别按２、３、５、７、１０ｍｇ／ｋｇ静脉注射ＨｐＤ，采用快速冰冻切片技术，于荧光显微镜下观察不同时间ＨｐＤ在真皮血管内、真皮血管外间质和表皮的分布情况。结果ＨｐＤ在真皮浅层血管内出现时间，２、３ｍｇ／ｋｇ二组为１５ｍｉｎ，５、７、１０ｍｇ／ｋｇ三组为５ｍｉｎ；ＨｐＤ在真皮血管外间质出现时间，各组依次为６０、６０、３０、１５、５ｍｉｎ；ＨｐＤ在表皮出现时间，３、５、７、１０ｍｇ／ｋｇ各组依次为９０、６０、３０、５ｍｉｎ，２ｍｇ／ｋｇ组观察至１２０ｍｉｎ未出现。结论运用光动力学疗法治疗鲜红斑痣的剂量应掌握在３～５ｍｇ／ｋｇ之间，注射完毕后即可开始照光，３ｍｇ／ｋｇ时照光时间不宜超过９０ｍｉｎ，５ｍｇ／ｋｇ时不宜超过６０ｍｉｎ。

A Fluorescence Microscopic Observation on the Distribution of HpD in the Skin of Normal Rabbits

Objective To seeking the proper dosage of hematoporphyrin derivative (HpD) and proper therapy time of photodynamic therapy of portwine stains. Methords Six rabbits each in five groups received intraveneously injected 2, 3, 5, 7 and 10 mg/kg of HpD, respectively. 5, 15, 30, 60, 90 and 120 min later skin samples were taken from the dorsal area and cryosections were prepared. The HpD distribution in the dermal vasculature, dermal interstitial tissue and epidermis was examined by fluorescence microscopy. The wavelength of excitation light was 405 nm. Results The time of appearance of HpD fluorescence in dermal superficial vasculature was 15 min in the 2 and 3 mg/kg groups and 5 min in the 5, 7 and 10 mg/kg groups. Appearance of fluorescence in dermal interstitial tissue was 60, 60, 30, 15 and 5 min in the 2, 3, 5, 7 and 10 mg/kg groups, respectively. The appearance of fluorescence in the epidermis was 90, 60, 30 and 5 min in the 3, 5, 7 and 10 mg/kg groups, respectively. No fluorescence at all was observed in the epidermis in the 2 mg/kg group up to 120 min after HpD injection. Conclusions If photodynamic therapy is applied to treat the portwine stains, the proper dosage of HpD should be 3-5 mg/kg and the irradiation may be carried out immediately after i.v. injection of HpD. The exposure time should be limited to 90 minutes at the HpD dose of 3 mg/kg, or 60 min at the HpD dose of 5 mg/kg.