中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (7): 476-481.doi: 10.12144/zgmfskin202507476

• 论著 • 上一篇    下一篇

儿童鲜红斑痣皮肤镜血管特征与海姆泊芬-光动力疗效的相关性研究

张升1,陈见友1,王秀伟2,程毅菁3,刘晓雁1,张高磊1,苏伟1   

  1. 1首都医科大学附属首都儿童医学中心皮肤科，北京，100020；2北京市儿童发育与营养学重点实验室，转化医学研究室，北京，100020；3首都儿科研究所儿童健康大数据研究中心，北京，100020
  • 出版日期:2025-07-15 发布日期:2025-07-04

Correlation between dermoscopic vascular characteristics and efficacy of hematoporphyrin monomethyl ether-photodynamic therapy on port wine stain in children

ZHANG Sheng1, CHEN Jianyou1, WANG Xiuwei2, CHENG Yijing3, LIU Xiaoyan1, ZHANG Gaolei1, SU Wei1   

  1. 1 Department of Dermatology, Capital Center for Children's Health, Capital Medical University, Beijing 100020, China; 2 Beijing Municipal Key Laboratory of Child Development and Nutriomics, Translational Medicine Laboratory, Capital Institute of Pediatrics, Beijing 100020, China; 3 Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China
  • Online:2025-07-15 Published:2025-07-04

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摘要： 目的：明确儿童鲜红斑痣（port-wine stain,PWS)皮肤镜下血管特征与海姆泊芬-光动力(HMME-PDT）治疗鲜红斑痣的疗效的相关性。方法：收集2020年3月至2022年12月在我院皮肤科行HMME-PDT治疗PWS患儿的临床资料。皮肤镜拍摄皮损部位图片，记录血管模式。以5 mg/kg剂量静脉注射海姆泊芬，皮损部位进行532 nm LED光源照射，治疗间隔8周。评估HMME-PDT治疗PWS的临床疗效，记录不良反应事件。采用Stata 15.1软件分析儿童PWS皮肤镜下血管类型与HMME-PDT疗效的相关性。结果：共纳入113例，男52例，女61例，年龄1~12岁；皮肤镜下皮损呈6种血管类型，分别为线状32例（28.3%）、点球状8例（7.1%）、短棒状29例（25.7%）、网状15例（13.3%）、混合型18例（15.9%）和红色均一背景11例（9.7%）；经HMME-PDT治疗3次后，点球状、短棒状、线状血管、网状、混合型和红色均一背景的痊愈率分别为100.0%、65.5%、59.3%、20.0%、16.7%和0%。其中点球状、短棒状和线状的疗效明显优于其他类型，差异具有统计学意义（P＜0.05）。结论：PWS皮肤镜下血管类型与HMME-PDT的疗效有显著相关性，点球状、短棒状和线状的疗效好。

关键词: 海姆泊芬, 光动力, 儿童, 鲜红斑痣, 皮肤镜

Abstract: Objective: To investigate the correlation between dermoscopic vascular features of port-wine stain (PWS) in children and efficacy of hematoporphyrin monomethyl ether-photodynamic therapy (HMME-PDT) for PWS. Methods: Clinical data of children with PWS treated with HMME-PDT of our hospital from March 2020 to December 2022 were retrospectively analyzed. Dermoscopic images of lesions were captured to classify vascular patterns. HMME (5 mg/kg) was intravenously injected, followed by irradiation with a 532 nm LED light source at 8-week intervals. Clinical efficacy and adverse events were recorded. Statistical analysis was performed using Stata 15.1 to assess the correlation between dermoscopic vascular types and therapeutic outcomes. Results: A total of 113 children (52 males, 61 females; age range 1 to 12 years) were included. Dermoscopic vascular patterns were classified into six types: linear (32 cases, 28.3%), dotted-globular (8 cases, 7.1%), short rod-like (29 cases, 25.7%), reticular (15 cases, 13.3%), mixed (18 cases, 15.9%), and homogeneous red background (11 cases, 9.7%). After three HMME-PDT sessions, the complete remission rates for these types were 100.0%, 65.5%, 59.3%, 20.0%, 16.7%, and 0.0%, respectively. The dotted-globular, short rod-like, and linear types showed significantly better efficacy compared to other types (P＜0.05). Conclusion: Dermoscopic vascular patterns are significantly correlated with HMME-PDT efficacy, dotted-globular, short rod-like and linear have better efficacy.

Key words: hematoporphyrin monomethyl ether, photodynamic therapy, children, port-wine stain, dermoscopy