摘要目的:比较宽谱强脉冲光OPT-IPL与窄谱强脉冲光DPL治疗玫瑰痤疮相关红斑及毛细血管扩张的疗效和安全性。方法:回顾2016年10月至2019年12月于中国医学科学院皮肤病医院激光科确诊并接受强脉冲光治疗的54例玫瑰痤疮患者，年龄19~56岁，病程0.2~10年。22例采用OPT-IPL治疗，32例DPL治疗，所有患者均至少完成1次治疗及随访。根据临床红斑评定量表（CEA）、医生整体评价法（PGA）评价疗效，同时评价不良反应。采用广义线性混合效应模型比较不同组别及治疗次数的CEA评分、PGA评分差异。结果:OPT-IPL组分别有22例、17例、10例完成了1、2、3次治疗，能量密度（16.57±1.21）J/cm 2，DPL组分别为32例、25例、16例，能量密度（9.76±0.61）J/cm 2。OPT-IPL组治疗前及1、2、3次治疗后CEA评分为2.38±0.84、2.29±0.75、1.94±0.66、1.90±0.66，DPL组为2.25±0.77、2.16±0.77、1.84±0.81、1.47±0.81，不同组别和治疗次数的红斑严重程度无交互作用（ F=0.57， P=0.638），CEA评分差异无统计学意义（ F=0.84， P=0.360），而不同治疗次数CEA评分差异有统计学意义（ F=17.90， P< 0.001），与治疗前比较，随着治疗次数的增加，CEA评分逐渐降低（均 P< 0.05）。OPT-IPL组治疗1、2、3次治疗后PGA评分为0.39±0.71、0.82±0.92、0.55±0.80，DPL组为0.61±0.77、1.34±1.09、1.53±1.38，不同组别和治疗次数的疗效无交互作用（ F=1.62， P=0.202），PGA评分差异无统计学意义（ F=3.93， P=0.050），而不同治疗次数PGA评分差异有统计学意义（ F=19.33， P< 0.001），与第1次治疗后相比，随着治疗次数的增加PGA评分逐渐提升（均 P< 0.001）。两组患者治疗后均未出现水疱、结痂等不良反应，两组色素沉着、红斑加重、出现丘疹或丘疹较前增多的发生率差异无统计学意义（均 P> 0.05）。 结论:DPL治疗玫瑰痤疮相关红斑及毛细血管扩张的疗效和安全性与OPT-IPL相当，但所需治疗能量密度更低。

abstractsObjective:To compare the efficacy and safety of broad-band intense pulsed light (OPT-IPL) versus narrow-band intense pulsed light (DPL) in the treatment of rosacea-associated erythema and telangiectasia.Methods:Fifty-four rosacea patients who received treatment with intense pulsed light were collected from Laser Department, Hospital of Dermatology, Chinese Academy of Medical Sciences from October 2016 to December 2019, and clinical data were retrospectively analyzed. Their age ranged from 19 to 56 years, and disease duration ranged from 0.2 to 10 years. Of the 54 patients, 22 were treated with OPT-IPL, and 32 were treated with DPL. All patients completed at least one session of treatment and follow-up. Therapeutic efficacy was evaluated by using clinician erythema assessment (CEA) and physician global assessment (PGA) scales, and adverse reactions were assessed. A generalized linear mixed model was used to analyze differences in CEA and PGA scores among different groups and treatment sessions.Results:In the OPT-IPL group, 22, 17 and 10 cases completed 1, 2 and 3 sessions of treatment respectively, with the energy fluence being 16.57±1.21 J/cm 2. In the DPL group, 32, 25 and 16 cases completed 1, 2 and 3 sessions of the treatment respectively, with the energy fluence of 9.76±0.61 J/cm 2. Before the start of treatment and after 1, 2 and 3 sessions of treatment, the CEA scores were 2.38±0.84, 2.29±0.75, 1.94±0.66 and 1.90±0.66 respectively in the OPT-IPL group, and 2.25±0.77, 2.16±0.77, 1.84±0.81 and 1.47±0.81 respectively in the DPL group. As far as the CEA score was concerned, there was no interaction between the groups and treatment sessions ( F=0.57, P=0.638) , and no significant difference between the OPT-IPL group and DPL group ( F=0.84, P=0.360) , but a significant difference was observed among different sessions of treatment ( F=17.90, P< 0.001) , and the CEA score gradually decreased along with the increase of treatment sessions compared with that before treatment (all P< 0.05) . After 1, 2 and 3 sessions of treatment, the PGA scores were 0.39±0.71, 0.82±0.92 and 0.55±0.80 respectively in the OPT-IPL group, and 0.61±0.77, 1.34±1.09 and 1.53±1.38 respectively in the DPL group. As far as the PGA score was concerned, there was no interaction between the groups and treatment sessions ( F=1.62, P=0.202) , and no significant difference between the OPT-IPL group and DPL group ( F=3.93, P=0.050) , but there was a significant difference among different sessions of treatment ( F=19.33, P< 0.001) . Compared with the PGA score after 1 session of treatment, the PGA score gradually increased along with the increase of treatment sessions (all P< 0.001) . After treatment, no adverse reactions, such as blisters and crusts, occurred in either of the 2 groups, and there was no significant difference in the incidence of pigmentation, erythema aggravation, papules or increase in papule count between the 2 groups (all P> 0.05) . Conclusion:The efficacy and safety of DPL are comparable to those of OPT-IPL in the treatment of rosacea-related erythema and telangiectasia, but lower energy fluence is required.