【摘要】 目的：评价光动力治疗日光角化病（Actinickeratosis,AK）的临床疗效，并探讨影响疗效的相关因素。方法：回顾性分析2017年6月-2022年3月笔者医院采用光动力治疗AK的患者临床资料，并随访其临床疗效，进行单因素分析筛选后使用有序多分类Logistic回归分析探讨影响疗效的主要因素。结果：共纳入116例AK患者，其中49例（42.24%）完全缓解，35例（30.17%）部分缓解，32例无效（27.59%），总有效率72.41%；治疗次数3次及以上的AK患者治疗有效率为90.54%。有序多分类Logistic回归分析结果显示治疗次数，皮损分级、皮损数量是影响治疗疗效的主要因素；治疗1～2次者疗效比治疗3次及以上者差（OR=0.036,P<0.05）；皮损分级低者（Olsen1～2级）疗效优于皮损分级（3级）高者（OR=3.848,P<0.05）；皮损数量少者疗效较皮损多发者（≥3个）疗效更佳（OR=17.167,P<0.05）。治疗期间AK患者均未发生严重的不良反应。结论：单发、皮损厚度偏薄的日光角化病患者进行光动力治疗效果更佳，且治疗次数以3次以上为宜。性别、年龄、皮肤类型、皮损直径等均不影响疗效。更多还原

【Abstract】 Objective To assess the clinical efficacy of photodynamic therapy in the treatment of actinic keratosis(AK), and explore its main influencing factors. Methods The AK patients treated by photodynamic therapy in the investigator’s hospital from June 2017 to March 2022 were retrospectively analyzed and followed up. The main af fecting factors on the treatment efficacy were done by univariate analysis and ordered multivariate logistic regression analysis. Results A total of 116 AK patients were included in the study. Of these, 49 patients(42.24%) achieved complete remission, 35 patients(30.17%) achieved partial remission, 32 patients were inef fective(27.59%), and the total ef fective rate was 72.41%. Through ordered multivariate logistic regression analysis, the ef fective rate was 90.54% for patients with 3 or more times treatments; The results showed that the number of treatment times, the classification and the number of skin lesions were the main factors af fecting the therapeutic efficacy. The patients who received 1-2 times had inferior efficacy to those who had 3 or more times of treatment(OR=0.036,P<0.05); The efficacy of patients with low-grade skin lesions(Olsen Grade 1-2) was better than those with high-grade skin lesions(Grade 3)(OR=3.848,P<0.05); less number of lesions predicted better outcome than those with multiple lesions(≥3 lesions)(OR=17.167, P<0.05). No patients had serious adverse reactions during treatment. Conclusion AK Patients who had fewer, thinner skin lesions would have better therapeutic efficacy, and the times of treatment should be 3 or more. Sex, age,skin type, and lesion size did not af fect the therapeutic efficacy.更多还原