张剑虹 吴岚曦 周楠 罗洋

[摘要]目的：回顾性分析540nm强脉冲光治疗蠕形螨阳性玫瑰痤疮后期遗留毛细血管扩张皮损患者的疗效。方法：收集蠕形螨阳性玫瑰痤疮经奥硝唑为主的序贯性治疗后再行540nm强脉冲光治疗的317例遗留毛细血管扩张皮损患者的数据，统计分析治疗次数、患者年龄、皮损面积与疗效之间的关系及复发人数。结果：疗程结束后统计，治疗次数与疗效之间具有统计学意义（P<0.05）;患者的年龄与疗效之间无统计学意义（P=0.9165）;患者皮损面积与疗效之间有统计学意义（P<0.05）;疗程结束后，随访6个月内有21例玫瑰痤疮复发。结论：经奥硝唑序贯性治疗后的蠕形螨阳性玫瑰痤疮患者再采用540nm强脉冲光治疗具有较好疗效。

[关键词]玫瑰痤疮;毛细血管扩张;强脉冲光;奥硝唑

[中图分类号]R758.73+4    [文献标志码]A    [文章编号]1008-6455（2021）04-0036-05

Intense Pulsed Light for Treatment of Demodex-positive Late-stage Rosacea： A Retrospective Analysis

ZHANG Jian-hong1，WU Lan-xi 1， ZHOU Nan1， LUO Yang2

（1.The Second Clinical Medical College， Lanzhou University， Lanzhou 730000，Gansu，China; 2. Department of Dermatology， the 940th Hospital of Joint Logistics Support Force of China Peoples Liberation Army， Lanzhou 730050，Gansu，China）

Abstract： Objective To retrospectively analyze the efficacy of 540nm intense pulsed light in treating patients with Demodex-positive rosacea at the late-stage of telangiectasia. Methods Demodex-positive rosacea was treated with ornidazole-based sequential inertial treatment before 540nm intense pulsed light treatment， the data of 317 patients with Demodex-positive rosacea at the late-stage rosacea after the treatment with 540nm intense pulsed light were collected， and the relationship between the time of treatments， the age of the patients， the area of the lesions and the curative effect， and the number of relapses were statistically analyzed. Results After the course of treatment， there was a statistically significant difference between the time of treatments and curative effect （P<0.05）.There was no statistically significant difference between the patient's age and curative effect （P= 0.9165）， there was a statistically significant difference between the area of skin lesions and curative effect （P<0.05），21 cases of rosacea patients recurred within 6 months of follow-up after the end of treatment. Conclusion After sequential treatment with ornidazole， Demodex-positive rosacea with 540nm intense pulsed light treatment have a certain effect.

Key words： rosacea; telangiectasia; intense pulsed light; ornidazole

玫瑰痤瘡是一种常见的以面部皮肤血管和皮脂腺为单位的慢性炎症性皮肤病。表现为面中部为主的一过性或持久性红斑、毛细血管扩张、丘疹、脓疱、结节[1-2]。玫瑰痤疮易反复发作，严重影响患者的身心健康[3-4]。目前的治疗方式有药物治疗和光电、手术等非药物治疗[5-9] 。美国一项调查研究显示玫瑰痤疮患者对目前治疗手段所获得的疗效满意度不足一半[10]，因此，探索新的有效治疗方式是有必要的。笔者科室前期研究发现通过奥硝唑为主的序贯性治疗方法抗蠕形螨及修复炎症皮损治疗玫瑰痤疮具有明显疗效，通常意义的序贯治疗为同一种药物剂型的转变[11]，而笔者在治疗蠕形螨阳性玫瑰痤疮中所采用的序贯性治疗为初期口服奥硝唑片以抗蠕形螨、抗炎治疗，根据患者不同的面部状况治疗2～4个疗程（2周/疗程），奥硝唑治疗1周后，给予患者外用重组牛碱性成纤维细胞因子凝胶以修复皮损，共治疗4～8周，可明显改善蠕形螨阳性的玫瑰痤疮患者面部炎性红斑、丘疹、脓疱等症状，但对毛细血管扩张症状无效[12-13]。……