钛提升文章（翻译版）

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钛提升文章（翻译版）

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Lasers in Medical Science (2023) 38:272

https://doi.org/10.1007/s10103-023-03936-6

Lasers in Medical Science (2023) 38:272

https://doi.org/10.1007/s10103-023-03936-6

ORIGINAL ARTICLE

· Sang Jun Lee2 · Hwa Jung Ryu1

· Dong Hye Suh2 · Hyunwoo Park1

· Sang Jun Lee2 · Hwa Jung Ryu1

· Dong Hye Suh2 · Hyunwoo Park1

ORIGINAL ARTICLE

Skin rejuvenating eﬀect o[[f]] a combined triple-wavelength (755 nm,

三波长（755nm,810nm,1064nm）联合激光的皮肤年轻化效果评价：一项

Ju Young Jo1

初步研究

Ju Young Jo1

Received: 12 June 2023 / Accepted: 14 November 2023

Ju Young Jo1

Received: 12 June 2023 / Accepted: 14 November 2023

Abstract

With an increasing demand [[f]]or noninvasive skin rejuvenation techniques, several light-based devices have been introduced.

翻译：白玉博士，指导校正：杨蓉娅教授

Abstract

Due to its ability to deliver thermal energy [[f]]rom the superﬁcial to deeper levels of the dermis, a combined triple-wavelength

Abstract

Due to its ability to deliver thermal energy [[f]]rom the superﬁcial to deeper levels of the dermis, a combined triple-wavelength

With an increasing demand [[f]]or noninvasive skin rejuvenation techniques, several light-based devices have been introduced.

laser (755 nm, 810 nm, and 1064 nm) can be used [[f]]or skin rejuvenation. The objective of this study was to assess the eﬀec-

With an increasing demand [[f]]or noninvasive skin rejuvenation techniques, several light-based devices have been introduced.

Due to its ability to deliver thermal energy [[f]]rom the superﬁcial to deeper levels of the dermis, a combined triple-wavelength

摘要（Abstract）

tiveness and sa[[f]]ety of a combined triple-wavelength laser for skin rejuvenation. A total of 28 female patients seeking skin

Due to its ability to deliver thermal energy [[f]]rom the superﬁcial to deeper levels of the dermis, a combined triple-wavelength

laser (755 nm, 810 nm, and 1064 nm) can be used [[f]]or skin rejuvenation. The objective of this study was to assess the eﬀec-

rejuvenation treatment were included. All patients underwent ﬁve consecutive treatment sessions at a two-week interval.

laser (755 nm, 810 nm, and 1064 nm) can be used [[f]]or skin rejuvenation. The objective of this study was to assess the eﬀec-

tiveness and sa[[f]]ety of a combined triple-wavelength laser for skin rejuvenation. A total of 28 female patients seeking skin

Clinical improvement o[[f]] aging-related cutaneous change was noted by the treating dermatologists and patients. Biopsies were

随着对非侵入性皮肤年轻化技术的需求不断增加，多种基于光的设备被引入应用。联合三波长激光（755nm、

Clinical improvement o[[f]] aging-related cutaneous change was noted by the treating dermatologists and patients. Biopsies were

tiveness and sa[[f]]ety of a combined triple-wavelength laser for skin rejuvenation. A total of 28 female patients seeking skin

rejuvenation treatment were included. All patients underwent ﬁve consecutive treatment sessions at a two-week interval.

per[[f]]ormed on the faces of consenting patients before and two weeks after the ﬁnal treatment. Signiﬁcant clinical improve-

rejuvenation treatment were included. All patients underwent ﬁve consecutive treatment sessions at a two-week interval.

Clinical improvement o[[f]] aging-related cutaneous change was noted by the treating dermatologists and patients. Biopsies were

ments were observed by both patients and evaluating dermatologists. Based on the patient satis[[f]]action questionnaire, 78%

Clinical improvement o[[f]] aging-related cutaneous change was noted by the treating dermatologists and patients. Biopsies were

per[[f]]ormed on the faces of consenting patients before and two weeks after the ﬁnal treatment. Signiﬁcant clinical improve-

激光在皮肤年轻化治疗中的有效性与安全性。研究共纳入了28名女性患者，均接受了5次治疗，治疗间隔为2

o[[f]] patients reported a self-assessed improvement of more than 25%. Additionally, 86% of patients showed an improvement

per[[f]]ormed on the faces of consenting patients before and two weeks after the ﬁnal treatment. Signiﬁcant clinical improve-

ments were observed by both patients and evaluating dermatologists. Based on the patient satis[[f]]action questionnaire, 78%

o[[f]] more than 25% on objective assessment by dermatologists. Histopathological ﬁndings revealed increased collagen and

周。研究医生与患者评估并记录了衰老相关皮肤症状的临床改善情况。部分患者在知情同意后，在治疗前及末

o[[f]] more than 25% on objective assessment by dermatologists. Histopathological ﬁndings revealed increased collagen and

ments were observed by both patients and evaluating dermatologists. Based on the patient satis[[f]]action questionnaire, 78%

o[[f]] patients reported a self-assessed improvement of more than 25%. Additionally, 86% of patients showed an improvement

elastic bundles throughout the dermis. Except [[f]]or transient pain during treatment, no serious adverse eﬀects were reported.

o[[f]] patients reported a self-assessed improvement of more than 25%. Additionally, 86% of patients showed an improvement

o[[f]] more than 25% on objective assessment by dermatologists. Histopathological ﬁndings revealed increased collagen and

次治疗后2周接受了面部活检。患者和医生的评估结果均显示出显著改善；患者的自我评价显示，78%的患者

The ﬁndings o[[f]] this study suggest that the combined triple-wavelength laser may be an eﬀective and safe nonablative option

o[[f]] more than 25% on objective assessment by dermatologists. Histopathological ﬁndings revealed increased collagen and

elastic bundles throughout the dermis. Except [[f]]or transient pain during treatment, no serious adverse eﬀects were reported.

[[f]]or skin rejuvenation.

改善超过25%，另外，医生客观评价显示，86%的患者改善超过25%。组织病理学结果显示，真皮层中胶原和

[[f]]or skin rejuvenation.

elastic bundles throughout the dermis. Except [[f]]or transient pain during treatment, no serious adverse eﬀects were reported.

The ﬁndings o[[f]] this study suggest that the combined triple-wavelength laser may be an eﬀective and safe nonablative option

Keywords Combined triple-wavelength laser · Laser therapy · Skin rejuvenation · Selective photothermolysis

弹性纤维束均有所增加。除治疗过程中短暂疼痛外，无严重不良反应。本研究表明，联合三波长激光可能是一

[[f]]or skin rejuvenation.

Keywords Combined triple-wavelength laser · Laser therapy · Skin rejuvenation · Selective photothermolysis

[[f]]or skin rejuvenation.

种有效、安全的非剥脱性皮肤年轻化手段。

Keywords Combined triple-wavelength laser · Laser therapy · Skin rejuvenation · Selective photothermolysis

Introduction

引言（Introduction）

Introduction

An increasing demand [[f]]or skin rejuvenation has led to the

Introduction

An increasing demand [[f]]or skin rejuvenation has led to the

随着皮肤年轻化需求的上升，开发出了各种治疗

development o[[f]] various modalities ranging from surgical

An increasing demand [[f]]or skin rejuvenation has led to the

方式，包括手术和基于光的设备【1-3】。然而，手

methods to light-based devices [1–3]. However, surgical pro-

An increasing demand [[f]]or skin rejuvenation has led to the

development o[[f]] various modalities ranging from surgical

cedures o[[f]]ten have undesirable side eﬀects, such as pain,

术往往伴随一些不良反馈，如疼痛、瘢痕、神经损伤

cedures o[[f]]ten have undesirable side eﬀects, such as pain,

development o[[f]] various modalities ranging from surgical

methods to light-based devices [1–3]. However, surgical pro-

scarring, permanent nerve injury, or an extended recovery

methods to light-based devices [1–3]. However, surgical pro-

或较长的恢复期等。激光作为非手术替代方案，近年

cedures o[[f]]ten have undesirable side eﬀects, such as pain,

period. Recently, lasers have become increasingly popular as

cedures o[[f]]ten have undesirable side eﬀects, such as pain,

scarring, permanent nerve injury, or an extended recovery

a non-surgical alternative [[f]]or skin rejuvenation due to their

来因其效果显著且不良反应较少而受到青睐【3】。

a non-surgical alternative [[f]]or skin rejuvenation due to their

scarring, permanent nerve injury, or an extended recovery

period. Recently, lasers have become increasingly popular as

eﬀectiveness and [[f]]ewer associated side eﬀects [3].

period. Recently, lasers have become increasingly popular as

早期使用的剥脱性激光（如CO₂和铒激光）通过

a non-surgical alternative [[f]]or skin rejuvenation due to their

Initially, ablative lasers, such as CO2 and erbium lasers,

a non-surgical alternative [[f]]or skin rejuvenation due to their

eﬀectiveness and [[f]]ewer associated side eﬀects [3].

were utilized, which induced the removal o[[f]] the epidermis,

表皮去除，真皮胶原收缩实现即刻紧致的效果【4】，之

were utilized, which induced the removal o[[f]] the epidermis,

eﬀectiveness and [[f]]ewer associated side eﬀects [3].

Initially, ablative lasers, such as CO2 and erbium lasers,

were utilized, which induced the removal o[[f]] the epidermis,

Ju Young Jo and Dong Hye Suh contributed equally to this work.

Hwa Jung Ryu
Hwa Jung Ryu
Hwa Jung Ryu

Ju Young Jo and Dong Hye Suh contributed equally to this work.

Hwa Jung Ryu
Hwa Jung Ryu

resulting in instant skin tightening through collagen shrink-

age [4]. Additionally, as the skin heals over the months [[f]]ol-

resulting in instant skin tightening through collagen shrink-

lowing laser resur[[f]]acing, long-term collagen remodeling

后的几个月，随着皮肤的愈合，胶原的重塑，出现进

lowing laser resur[[f]]acing, long-term collagen remodeling

resulting in instant skin tightening through collagen shrink-

age [4]. Additionally, as the skin heals over the months [[f]]ol-

occurs, which [[f]]urther enhances the rejuvenating eﬀects of

age [4]. Additionally, as the skin heals over the months [[f]]ol-

一步的年轻化改善【3】。剥脱性激光的弊端在于会

lowing laser resur[[f]]acing, long-term collagen remodeling

the treatment [3]. One o[[f]] the main drawbacks of ablative

lowing laser resur[[f]]acing, long-term collagen remodeling

occurs, which [[f]]urther enhances the rejuvenating eﬀects of

lasers is that they disrupt the epidermis, which leads to more

破坏表皮，导致恢复期较长【1，3，5，6】。因此，能

lasers is that they disrupt the epidermis, which leads to more

occurs, which [[f]]urther enhances the rejuvenating eﬀects of

the treatment [3]. One o[[f]] the main drawbacks of ablative

extended downtime [1, 3, 5, 6]. Due to this disadvantage, the

the treatment [3]. One o[[f]] the main drawbacks of ablative

够作用于真皮但不破坏表皮的非剥脱性激光的需求

lasers is that they disrupt the epidermis, which leads to more

demand [[f]]or nonablative lasers, which can deliver energy to

lasers is that they disrupt the epidermis, which leads to more

extended downtime [1, 3, 5, 6]. Due to this disadvantage, the

the dermis without disrupting the epidermis, has increased.

增加。

the dermis without disrupting the epidermis, has increased.

extended downtime [1, 3, 5, 6]. Due to this disadvantage, the

demand [[f]]or nonablative lasers, which can deliver energy to

Recently, multiple methods have become available [[f]]or

demand [[f]]or nonablative lasers, which can deliver energy to

当前已有多种非侵入性紧肤技术可用，包括激光、

the dermis without disrupting the epidermis, has increased.

noninvasive skin tightening, including laser therapy, radi-

the dermis without disrupting the epidermis, has increased.

Recently, multiple methods have become available [[f]]or

o[[f]]requency, ultrasound, and intense pulsed light [7, 8]. These

射频、超声和强脉冲光【7，8】，这些技术通过将能

o[[f]]requency, ultrasound, and intense pulsed light [7, 8]. These

Recently, multiple methods have become available [[f]]or

noninvasive skin tightening, including laser therapy, radi-

treatments generate targeted energy to elevate temperatures

量靶向导入真皮深层，使其温度升高【7，9】。非侵

noninvasive skin tightening, including laser therapy, radi-

o[[f]]requency, ultrasound, and intense pulsed light [7, 8]. These

in the deeper layers o[[f]] the skin [7, 9]. Thermal energy pro-

o[[f]]requency, ultrasound, and intense pulsed light [7, 8]. These

treatments generate targeted energy to elevate temperatures

duced by noninvasive rejuvenation techniques does not dis-

入性抗衰技术产生的热能可以在不破坏表皮的同时达

duced by noninvasive rejuvenation techniques does not dis-

treatments generate targeted energy to elevate temperatures

in the deeper layers o[[f]] the skin [7, 9]. Thermal energy pro-

rupt the epidermis and induces collagen remodeling [9].

到真皮重塑的目的【9】。三波长半导体激光（

in the deeper layers o[[f]] the skin [7, 9]. Thermal energy pro-

duced by noninvasive rejuvenation techniques does not dis-

Triple-wavelength (755 nm, 810 nm, and 1064 nm) diode

duced by noninvasive rejuvenation techniques does not dis-

rupt the epidermis and induces collagen remodeling [9].

lasers are devices that emit simultaneous wavelengths and

rupt the epidermis and induces collagen remodeling [9].

Triple-wavelength (755 nm, 810 nm, and 1064 nm) diode

are commonly used [[f]]or hair removal. It can penetrate multi-

的激光，是一种常用于脱毛的设备。该设备可通过激

are commonly used [[f]]or hair removal. It can penetrate multi-

Triple-wavelength (755 nm, 810 nm, and 1064 nm) diode

lasers are devices that emit simultaneous wavelengths and

ple dermis layers, delivering thermal energy [[f]]rom the super-

lasers are devices that emit simultaneous wavelengths and

are commonly used [[f]]or hair removal. It can penetrate multi-

光穿透并作用于皮肤多个层次，将热能从浅层导入真

ﬁcial to deeper levels o[[f]] the dermis [10–14]. This induces

are commonly used [[f]]or hair removal. It can penetrate multi-

ple dermis layers, delivering thermal energy [[f]]rom the super-

皮深层【10-14】，随后诱导真皮胶原重塑，因此，

ple dermis layers, delivering thermal energy [[f]]rom the super-

ﬁcial to deeper levels o[[f]] the dermis [10–14]. This induces

Vol.:(0123456789)

dermhj@korea.ac.kr

Hospital, Ansan-Si, Republic o[[f]] Korea

dermhj@korea.ac.kr

Hospital, Ansan-Si, Republic o[[f]] Korea

Republic o[[f]] Korea

Hospital, Ansan-Si, Republic o[[f]] Korea

Republic o[[f]] Korea

dermhj@korea.ac.kr

Page 2 o[[f]] 8

Lasers in Medical Science (2023) 38:272

该设备也具有非侵入性皮肤年轻化的作用。本研究旨

subsequent dermal collagen remodeling, which makes these

devices an alternative [[f]]or nonablative skin rejuvenation.

在评估三波长（755nm,810nm,644nm）激光设备用

This study evaluated the skin rejuvenating eﬀect and

于皮肤年轻化时的临床疗效与安全性。

sa[[f]]ety of a simultaneous triple-wavelength diode laser device

emitting 755 nm, 810 nm, and 1064 nm.

Materials and methods

材料与方法（Materials and Methods）

积能量达到15 kJ作为治疗终点。第二阶段采用SHR

pain. Second, SHR mode was utilized, delivering laser

energy in repetitive low-energy pulses. The moving tech-

模式，以连续低能量脉冲方式传递激光能量。治疗过

nique was used to deliver 8.0 kJ (100 s) at 4 J/cm2 ﬂuence

程中使用移动技术，以4 J/cm²的能量密度在全脸进

on the whole [[f]]ace. Throughout the entire treatment, three

wavelengths (755 nm, 810 nm, and 1064 nm) were delivered

行扫描，累积能量为8.0 kJ（100s）。整个治疗过程

simultaneously in each shot. Be[[f]]ore each treatment session,

中，每次激光照射均同时发射三种波长（755nm、

cool ultrasound gel was applied. All patients received ﬁve

successive treatment sessions at a two-week interval.

Patients

本研究共纳入28名希望进行皮肤年轻化（包括

Clinical assessment

凝胶。所有患者共接受五次治疗，每次间隔两周。

面部紧致）治疗的患者。所有患者于2022年3月至

This study included 28 patients who desired skin rejuvena-

tion, including [[f]]acial tightening. The patients were treated at

the Arumdaun Nara clinic and Department o[[f]] Dermatology,

Arumdaun Nara皮肤科诊所接受治疗。本研究方案

Korea University Ansan Hospital, South Korea, between

经高丽大学安山医院伦理委员会审批（IRB编号：

March 2022 and February 2023. The study protocol was

reviewed and approved by the Institutional Review Board o[[f]]

Korea University Ansan Hospital (IRB no. 2022AS0052).

的潜在益处与风险，并签署了书面知情同意书。

Be[[f]]ore the procedure, all participants were informed about

the potential beneﬁts and risks o[[f]] the treatment, and written

in[[f]]ormed consent was obtained from each patient.

Inclusion and exclusion criteria

纳入和排除标准（Inclusion and exclusion criteria）

有瘢痕疙瘩病史、活动性皮肤感染或全身性疾病

Patients with a history o[[f]] keloid, active cutaneous infec-

tions, or uncontrolled general disease were excluded [[f]]rom

活动期的患者被排除。此外，近6个月内接受过激光

the study. Additionally, individuals who had undergone laser

治疗、化学换肤或A型肉肉毒素注射者，近12个月内

treatment, chemical peeling, or botulinum toxin injection

within the last six months, plastic surgery within the previ-

接受过整形手术者，或近24个月内接受过填充剂注射

ous 12 months, or had received ﬁller injection within the last

者，也被排除。孕妇或哺乳期女性亦未被纳入研究。

patients were not included in the study.

Laser treatment

激光治疗（Laser treatment）

本研究所用设备为三波长半导体激光（SOPRA-

The device used in the study was a triple-wavelength diode

laser (SOPRANO TITANIUM, Alma Lasers, Israel). Three

NO TITANIUM，以色列飞顿激光公司）。该设备可

wavelengths (755 nm, 810 nm, and 1064 nm) are emitted

同时发射三种波长激光（755 nm、810 nm 和 1064 nm），

simultaneously, almost equally contributing to the gener-

ated ﬂuence.

三种波长的能量平均分布于总输出能量中。

The study visit and design are summarized in Supple-

研究访问流程和设计详见补充图1。患者在治疗

mentary Fig. 1. Patients applied a local anesthetic cream (a

eutectic mixture o[[f]] 2.5% lidocaine HCl and 2.5% prilocaine;

前于面部涂抹局部麻醉膏（含2.5%盐酸利多卡因与

Taiguk Pharm Co., Ltd., Gyeonggi, Republic o[[f]] Korea) to

their [[f]]ace for 40 min before the procedure. The treatment

was divided into two stages. Firstly, in STACK mode, we set

韩国京畿道太），持续40分钟。治疗分为两个阶段。

the desired total energy (kJ) a[[f]]ter conﬁguring the ﬂuence (J/

第一阶段为STACK模式，在设定能量密度（J/cm²）

cm2). Each shot is per[[f]]ormed by ﬁxing the handheld probe

on the desired area and applying stacking repetitions (2/3/4/5

后设定总能量（kJ）。通过将手持探头固定于目标区

stack) in sequence. In this study, a ﬂuence o[[f]] 5 J/cm2 per

域，依次进行2、3、4、5次堆叠式照射。本研究中，

shot was stacked ﬁve times and applied to both cheeks. The

treatment was usually continued until a cumulative dose o[[f]]

每次照射的能量密度为5 J/cm²，共堆叠5次应用于双

颊。在患者主诉无严重疼痛的情况下，通常持续至累

Clinical photographs, three-dimensional (3D) images, and

临床评估与组织病理学检查

ultraviolet (UV) light photographs were obtained at baseline,

（Clinical Assessment & Histopathological Examination）

be[[f]]ore each treatment session, and two weeks after the ﬁnal

在基线时、每次治疗前以及最终治疗后两周，分

treatment. The clinical photographs were acquired using a

digital camera (EOS 80D; Canon KK, Tokyo, Japan), while

别采集了临床照片、三维（3D）图像和紫外线（UV）

the 3D photographs and UV photographs were captured

图像。临床照片由数码相机（佳能 EOS 80D，日本

using a 3D camera (Li[[f]]eViz® Inﬁnity; QuantiﬁCare, Biot,

France) and DermaVision™ (OptoBioMed Co., Kangwon,

东京佳能公司）拍摄，三维图像和UV图像分别由

Korea), respectively. The patients were positioned consist-

Li[[f]]eViz® Infinity三维相机（法国QuantifiCare公司）和

ently under uni[[f]]orm lighting conditions for all imaging

DermaVision™（韩国OptoBioMed公司）获取。所

modalities.

Be[[f]]ore each subsequent treatment, we conducted a patient

有图像均在统一光照条件下拍摄，且患者姿势保持一致。

inquiry regarding any adverse eﬀects they may have experi-

在每次后续治疗前，我们会询问患者在上一次治

enced a[[f]]ter the previous treatment. Additionally, after each

treatment, we requested patients to rate their procedural pain

疗后是否出现任何不良反应。此外，在每次治疗后，我

level using the Numeric Rating Scale (NRS).

们要求患者使用数字评分量表（NRS）对治疗过程中

At the ﬁnal visit, objective assessments [[f]]or each patient

were conducted by two blinded dermatologists. In addition,

疼痛的程度进行评分。

the patients were asked about their improvement [[f]]or sub-

在最终一次随访中，两位设盲皮肤科医生对每位

jective evaluations. Clinical improvement was assessed by

evaluating signs o[[f]] aging, particularly in the mid-face (zygo-

患者进行了客观评估。此外，患者还进行了主观改善

matic wrinkles or mid-cheek [[f]]urrows, nasolabial folds, and

评估。临床改善评估主要针对衰老迹象，尤其是中面

perioral expression wrinkles on the cheek) and the lower

[[f]]ace (marionette lines and jowl sagging). Both the patients

部（颧部皱纹或中颊沟、鼻唇沟以及口周面颊部的表

and dermatologists used the [[f]]ollowing scoring scales:

情纹）和下面部（木偶纹和下颌松弛）。患者与医生

均使用以下评分标准：

上述评分标准基于医生整体评估系统（PGA）设计【

The scoring system above was designed based on the

Physician’s Global Assessment (PGA) system [5, 15]. For

the comprehensibility o[[f]] result analysis, we utilized identi-

工具。

cal tools [[f]]or both objective and subjective scoring systems.

Histopathological examination

组织病理检测（Histopathological examination）

I[[f]] a patient gave consent, punch biopsies were obtained

若患者签署同意书，在治疗前从一侧耳后区域取

[[f]]rom one side of the post-auricular area prior to treatment

and [[f]]rom the opposite side of the post-auricular site after

穿刺活检标本，治疗后从对侧耳后区域再次采样。

Lasers in Medical Science (2023) 38:272

Page 3 o[[f]] 8

标本随后进行苏木精-伊红（H&E）染色、Masson三

treatment. The specimens were examined by hematoxylin

and eosin (H&E) staining, Masson’s trichrome (MT), and

色染色和Victoria蓝染色处理与分析。

Victoria blue staining.

数据分析（Statistical analysis）

Statistical analysis

Statistical analysis was per[[f]]ormed using SPSS version

使用SPSS 25版统计软件进行统计分析。每次治

疗结束后，使用重复测量时间的累积链接混合模型（

scores were analyzed using a cumulative link mixed model

[[f]]or repeated measures time (CLMM-RM). A probability

CLMM-RM）分析疼痛评分。概率阈值<0.05被认为

threshold o[[f]] < 0.05 was considered statistically signiﬁcant.

具有统计学意义。

Results

结果（Results）

A total o[[f]] 28 patients completed the treatment sessions and

共有28名患者完成了全部治疗及问卷调查，所

questionnaires. The demographic data o[[f]] all patients are

有患者均为韩国女性，Fitzpatrick皮肤类型为III或IV，

summarized in Table 1. All patients were Korean women

with Fitzpatrick skin types III and IV and ages ranging [[f]]rom

年龄范围30–73岁，平均年龄48.4岁，特征数据汇总

如表1。

Table 1 Demographic data o[[f]]

表1 受试者的特征性数据

enrolled patients

特征

Characteristic

数值

Value

Sex, n (%)

性别

女性

Female

Age, year

年龄

Range

范围

平均（SD）

Mean (SD)

Fitzpatrick skin

Fitzpatrick

type, n (%)

皮肤类型

Type III

III型

IV型

Type IV

图1展示了治疗后的主观与客观评估结果。在5次

Figure 1 illustrates subjective and objective evalua-

tions a[[f]]ter treatment. Both the patients and dermatolo-

治疗后，患者与皮肤科医生均观察到明显改善。约

gists observed a signiﬁcant improvement a[[f]]ter ﬁve treat-

ment sessions. Approximately 78% o[[f]] patients reported

a sel[[f]]-assessed improvement of more than 25%, and the

mean overall subjective improvement score was 3.5 ± 1.2

患者改善超过25%，平均客观评分为3.3±0.8（平均

(mean ± SD). The objective score, on which the derma-

tologists reached a consensus, indicated that about 86%

值±SD）。

o[[f]] patients showed an improvement of more than 25%,

治疗结束后，患者与医生均观察到临床改善。治疗前

and the mean overall objective improvement score was

后的临床照片、紫外图像和3D图像对比显示明显改

Patients and dermatologists noted clinical improve-

善，包括法令纹变浅（图2）、肤色提亮（图3）、木

ments a[[f]]ter completing all scheduled treatment sessions.

Comparing clinical photographs, UV photographs and

偶纹与下颌缘松弛减轻（图4）。除短暂疼痛（治疗

后即缓解）外，无明显不良反应；NRS疼痛评分平均

improvements were observed, including shallower nasola-

bial [[f]]olds (Fig. 2), brightness of skin (Fig. 3), and reduc-

低于3分，并随疗程推进而逐步下降（p = 0.0152，

tion o[[f]] marionette line laxity and jowl sagging (Fig. 4).

见补充图2）。

No signiﬁcant adverse eﬀects noted in any patients except

[[f]]or transient pain at treating time, which disappeared

共有13名患者接受了皮肤活检。Masson三色染

soon a[[f]]ter treatment. On average, the reported pain scores

色显示真皮层胶原含量增加；Victoria蓝染色显示真

remained below three on the NRS (Supplementary Fig. 2).

皮层分布的粗大的弹性纤维束增加（图5）。

As the treatment sessions progressed, there was a signiﬁ-

cant reduction in the patients’ reported pain NRS score

(p = 0.0152) (Supplementary Fig. 2).

Thirteen o[[f]] the patients in the study consented to a

skin biopsy. Histopathological ﬁndings a[[f]]ter Masson’s

trichrome stain show increased collagen density in the

dermis (Fig. 5). A[[f]]ter Victoria blue staining of the tissue,

many thick elastic bundles were observed throughout the

dermis (Fig. 5).

图1.改善评分问卷结果：(a)患

Fig. 1 Results o[[f]] the improve-

者自我评价的主观分数（b）

ment questionnaire: (a) subjec-

皮肤科医生评价的客观分数

tive score results evaluated by

the patients themselves; (b)

objective score results assessed

by the dermatologists

Page 4 o[[f]] 8

Lasers in Medical Science (2023) 38:272

照片，（a）治疗前（b）第5

图2.一名57岁受试者的临床

Fig. 2 Clinical photographs o[[f]]

a 57-year-old [[f]]emale (a) before

treatment and (b) 2 weeks a[[f]]ter

ﬁve sessions o[[f]] treatment. Post-

treatment photographs showed

a remarkable clinical improve-

ment in nasolabial [[f]]olds (white

triangles)

令纹明显改善（白色箭头）

次治疗后2周，可见治疗后法

a,c）为治疗前，（b,d）为疗程结

图3.紫外线照片，（a,b）（c,d）

分别为63岁女性和38岁女性，（

Fig. 3 UV light photographs o[[f]]

(a, b) a 61-year-old [[f]]emale and

(c, d) a 38-year-old [[f]]emale (a,

c) be[[f]]ore treatment and (b, d)

treatment. A[[f]]ter completing all

scheduled treatment sessions,

both patients showed signiﬁcant

improvement in pigmentation

(white dashed circles)

色圆圈）。

束后2周，可见色斑明显改善（白

讨论（Discussion）

Discussion

Skin aging is an inevitable process inﬂuenced by both

皮肤老化是一个不可避免的过程，受到内在与外

intrinsic and extrinsic [[f]]actors. Intrinsic factors encompass

在因素的共同影响。内在因素包括遗传倾向和激素水

genetic predisposition and hormonal inﬂuences, whereas

extrinsic [[f]]actors involve environmental stressors, such as

平的影响，外在因素则涉及环境压力，如紫外线暴露、

exposure to UV radiation, smoking, and alcohol consump-

吸烟和饮酒等【4，16】。虽然针对内在因素的干预

tion [4, 16]. While interventions targeting intrinsic [[f]]actors

pose challenges, behavioral modiﬁcations can eﬀectively

具有挑战性，但通过调整行为可有效减少外在因素的

reduce the impact o[[f]] extrinsic factors. Mechanistically,

the generation o[[f]] reactive oxygen species (ROS) or free

影响。内在和外在因素引起衰老的基本机制是活性氧

radicals, induced by these intrinsic and extrinsic [[f]]actors,

（ROS）或自由基的产生【16】，ROS会破坏细胞代

plays a signiﬁcant role in skin aging [16]. ROS disrupts

the cellular metabolic pathways and accelerates the deg-

谢通路，加速胶原和弹性纤维的降解，是导致皮肤衰

radation o[[f]] collagen and elastin ﬁbers, contributing to the

老的关键因素【4，16】。

mani[[f]]estations of skin aging [4, 16].

Lasers in Medical Science (2023) 38:272

Page 5 o[[f]] 8

Fig. 4 3D photographs o[[f]] a

图4. 42岁女性的3D影像，（

a.c.e）为治疗前，（b.d.[[f]]）

be[[f]]ore treatment and (b, d,

[[f]]) 2 weeks after ﬁve sessions

为5次治疗后2周，可见治疗

o[[f]] treatment. Posttreatment

photographs revealed notice-

后法令纹（黑色箭头）、下

able improvements in nasolabial

[[f]]olds (black triangles), jowl

颌缘松弛（白色箭头）以及

sagging (white triangles), and

overall [[f]]ace contouring

轮廓线的显著改善

In the past, surgical methods, such as rhytidectomy, were

以往常使用手术方法（如除皱术）改善皮肤松弛，

used to address skin laxity. However, these surgical meth-

但这类手术存在费用高、恢复期长及潜在不良反应（

ods had drawbacks, such as high ﬁnancial costs, prolonged

如瘢痕）等不足。随着对微创或无创性皮肤年轻化治

recovery periods, and potential adverse eﬀects like unwanted

scars. As the demand [[f]]or minimally invasive or noninvasive

疗需求的增长，CO₂和铒激光等剥脱性激光换肤技术

skin rejuvenation grew, ablative skin resur[[f]]acing techniques

被率先引入临床应用【3，7，17】。

utilizing CO2 and erbium lasers were ﬁrst introduced [3, 7,

这些激光主要靶向水分，通过气化富含水分的表

These lasers primarily target water, leading to the vapori-

皮实现皮肤剥脱，同时将热能传递至真皮层。若能量足

zation o[[f]] the water-rich epidermis and subsequent skin abla-

tion. During this process, thermal energy is delivered to the

够，可立即引起胶原纤维收缩【3】。随后的愈合

underlying dermis. I[[f]] suﬃcient energy is applied, immediate

过程将促进胶原重塑与新生，带来长期的年轻化

collagen molecule shrinkage occurs [3]. Subsequent wound

healing promotes collagen remodeling and new collagen [[f]]or-

效果【17】。

mation, which leads to long-term skin rejuvenating eﬀects

然而需注意，剥脱性激光会造成表皮损伤，从而

[17].

导致术后愈合慢，恢复期延长。为克服这一不足，近

However, it is important to note that ablative lasers have

associated post-procedural downtime due to epidermal dis-

年来出现了包括射频（RF）、强脉冲光（IPL）及激

ruption and the healing process. To overcome these draw-

光（532至1540 nm波长不等）等光电设备等替代方

backs, alternative approaches utilizing radio[[f]]requency (RF)

energy, as well as light-based devices, such as intense pulsed

案【1，7，17，18】。这些非剥脱性技术可在尽量减

light (IPL) or lasers o[[f]] various wavelengths ranging from

少表皮破坏的情况下，诱导胶原重塑，其原理是选择

nonablative techniques minimize epidermal disruption while

性光热作用，即特定波长的激光被靶色基选择性吸收

stimulating collagen remodeling through selective photo-

并转化为热能【7】。

thermolysis, in which laser energy o[[f]] a particular wavelength

Page 6 o[[f]] 8

Lasers in Medical Science (2023) 38:272

图5.MT染色：（a,c,e）为治疗前，（g,i,k）为治疗5次后2周；Victoria蓝染色（b,d,[[f]]）为治疗前，（hjl）为治疗5次后2周，可

Fig. 5 Histology with MT stain (X100) o[[f]] the facial skin (a, c, e)

be[[f]]ore treatment and (g, i, k) 2 weeks after ﬁnal treatment. Histol-

Fig. 5 Histology with MT stain (X100) o[[f]] the facial skin (a, c, e)

ogy with Victoria blue stain (X100) o[[f]] the facial skin (b, d, f) before

be[[f]]ore treatment and (g, i, k) 2 weeks after ﬁnal treatment. Histol-

见治疗后真皮内胶原纤维增多，粗大的弹性纤维束增多。

ogy with Victoria blue stain (X100) o[[f]] the facial skin (b, d, f) before

is selectively absorbed by a pigmented target and converted

to heat [7].

is selectively absorbed by a pigmented target and converted

The device utilized in this study was a diode laser system

to heat [7].

that emits three pulse wavelengths simultaneously (755 nm,

本研究所用设备为可同时发射755nm、810nm

The device utilized in this study was a diode laser system

与1064nm三种脉冲波长的半导体激光。这些波长常

that emits three pulse wavelengths simultaneously (755 nm,

monly employed [[f]]or hair removal procedures as they are

absorbed by melanin in the hair [[f]]ollicles [11–14]. Lasers

用于脱毛，因为它们能被毛囊中的黑色素吸收【11-14

monly employed [[f]]or hair removal procedures as they are

or light sources with wavelengths ranging [[f]]rom approxi-

】。600–1100nm波长范围内的激光或光源通常被黑

absorbed by melanin in the hair [[f]]ollicles [11–14]. Lasers

mately 600 to 1100 nm are known to be absorbed by mela-

or light sources with wavelengths ranging [[f]]rom approxi-

色素吸收。在此段光谱中，755nm翠绿宝石激光和

nin. Within this range, the 755-nm alexandrite laser and the

mately 600 to 1100 nm are known to be absorbed by mela-

nin. Within this range, the 755-nm alexandrite laser and the

spectrum, while the 1064-nm Nd:YAG laser is positioned

Nd:YAG激光位于末端【11】。

at the end [11].

spectrum, while the 1064-nm Nd:YAG laser is positioned

Shorter wavelengths, such as 755 nm and 810 nm, are

短波长如755nm和810nm更易被黑色素吸收，

at the end [11].

more readily absorbed by melanin, and they tend to scat-

Shorter wavelengths, such as 755 nm and 810 nm, are

并在穿透真皮时更易发生散射【13，14】。相比之

ter more as they penetrate the dermis [13, 14]. In contrast,

more readily absorbed by melanin, and they tend to scat-

longer wavelengths, such as 1064 nm Nd:YAG laser, have

下，长波长如1064nm Nd:YAG激光因黑色素吸收少

ter more as they penetrate the dermis [13, 14]. In contrast,

deeper penetration capabilities as they are less absorbed

longer wavelengths, such as 1064 nm Nd:YAG laser, have

而具备更深的穿透能力【14】。因此，三种波长组合

by melanin [14]. Hence, in the combination o[[f]] these three

deeper penetration capabilities as they are less absorbed

wavelengths, thermal energy is delivered on multiple dermis

可实现对真皮多个层次的热能输送。

by melanin [14]. Hence, in the combination o[[f]] these three

levels.

wavelengths, thermal energy is delivered on multiple dermis

尽管755nm和810nm波长主要被黑色素吸收，

Although to a lesser extent than melanin, the wavelengths

levels.

o[[f]] 755 nm and 810 nm are absorbed by hemoglobin, while

但也可被血红蛋白吸收；而1064nm波长则被水吸收

Although to a lesser extent than melanin, the wavelengths

the wavelength o[[f]] 1064 nm is absorbed by water [10].

【10】。由此产生的热能可向毛囊周围组织与血管广

o[[f]] 755 nm and 810 nm are absorbed by hemoglobin, while

Consequently, thermal energy is expected to be diﬀusely

the wavelength o[[f]] 1064 nm is absorbed by water [10].

Consequently, thermal energy is expected to be diﬀusely

treatment and (h, j, l) 2 weeks a[[f]]ter ﬁnal treatment. Posttreatment his-

tological analysis revealed the presence o[[f]] increased collagen and a

number o[[f]] thick elastic bundles throughout the dermis

treatment and (h, j, l) 2 weeks a[[f]]ter ﬁnal treatment. Posttreatment his-

tological analysis revealed the presence o[[f]] increased collagen and a

number o[[f]] thick elastic bundles throughout the dermis

delivered to the surrounding tissues and vasculature o[[f]] the

hair [[f]]ollicle, thereby initiating a cascade of inﬂammatory

delivered to the surrounding tissues and vasculature o[[f]] the

events and potentially [[f]]acilitating collagen remodeling [1,

hair [[f]]ollicle, thereby initiating a cascade of inﬂammatory

泛扩散，引发炎症反应级联反应，并启动胶原重塑过

events and potentially [[f]]acilitating collagen remodeling [1,

wavelength (755 nm, 810 nm, and 1064 nm) diode laser

程【1，10】。基于以上原因，三波长（755nm，

devices could be utilized as an alternative [[f]]or nonablative

wavelength (755 nm, 810 nm, and 1064 nm) diode laser

skin rejuvenation.

devices could be utilized as an alternative [[f]]or nonablative

In this study, both patients and evaluating dermatolo-

肤年轻化的手段。

skin rejuvenation.

gists reported noticeable clinical improvements in aging-

In this study, both patients and evaluating dermatolo-

在本研究中，患者和医生均观察到衰老相关皮肤

related skin changes, such as wrinkles, dyspigmentation, and

gists reported noticeable clinical improvements in aging-

skin sagging. The histopathological analysis also revealed

特征（如皱纹、色素沉着及松弛）的临床改善。组织

related skin changes, such as wrinkles, dyspigmentation, and

increased collagen and elastin bundles within the dermis.

skin sagging. The histopathological analysis also revealed

病理学分析也显示真皮层中胶原与弹性纤维束数量有

No serious adverse events were observed, except [[f]]or mild

increased collagen and elastin bundles within the dermis.

pain experienced during the treatment sessions, which sig-

所增加。除治疗过程中轻微疼痛外，未观察到严重不

No serious adverse events were observed, except [[f]]or mild

niﬁcantly decreased over time. This is among the ﬁrst stud-

pain experienced during the treatment sessions, which sig-

良反应，且疼痛程度随疗程推进明显降低。本研究是

ies to evaluate the eﬃcacy o[[f]] triple-wavelength diode laser

niﬁcantly decreased over time. This is among the ﬁrst stud-

devices in skin rejuvenation. Our ﬁndings demonstrate that

评估三波长半导体激光用于皮肤年轻化的初步探索之

ies to evaluate the eﬃcacy o[[f]] triple-wavelength diode laser

these devices exhibit remarkable skin rejuvenating eﬀects

devices in skin rejuvenation. Our ﬁndings demonstrate that

一，结果表明其具有显著疗效，恢复时间短，且无明

with minimal downtime and no signiﬁcant adverse events.

these devices exhibit remarkable skin rejuvenating eﬀects

In hair removal procedures, the 1064-nm wavelength is

显不良反应。

with minimal downtime and no signiﬁcant adverse events.

considered suitable [[f]]or Fitzpatrick skin types IV-VI because

In hair removal procedures, the 1064-nm wavelength is

this wavelength penetrates the deeper layer and is absorbed

considered suitable [[f]]or Fitzpatrick skin types IV-VI because

less by melanin [12]. Since our study included patients hav-

的脱毛治疗，因为该波长能深入真皮层，且不易被黑

this wavelength penetrates the deeper layer and is absorbed

ing skin types ranging [[f]]rom III to V, we were concerned

色素吸收【12】。本研究纳入的患者皮肤类型为III–V，

less by melanin [12]. Since our study included patients hav-

about post-procedure hyperpigmentation. However, no such

ing skin types ranging [[f]]rom III to V, we were concerned

about post-procedure hyperpigmentation. However, no such

Lasers in Medical Science (2023) 38:272

Page 7 o[[f]] 8

adverse eﬀects were reported in our study. It is important to

因此我们曾担心术后出现色素沉着问题，但并未观察

note that our study did not include patients with skin type

到此类不良反应。需注意的是，本研究未纳入皮肤类

VI; thus, [[f]]urther research is needed for this particular skin

type.

型VI的患者，因此未来仍需针对该皮肤类型开展进一

Our study has several limitations that should be acknowl-

步研究。

edged. Firstly, the sample size o[[f]] the study was insuﬃcient to

yield statistically signiﬁcant results. Secondly, the absence

本研究仍存在一定的局限性。首先，本研究的样

o[[f]] a control group limited our ability to make direct com-

本量不足，无法得出具有统计学意义的结果。其次，

parisons and draw ﬁrm conclusions about the eﬃcacy o[[f]]

未设置对照组，无法进行直接比较，未能得出关于治

the treatment. Lastly, the assessment o[[f]] clinical improve-

ments relied on patients’ reports and subjective evaluations

疗效果的确切结论。最后，临床改善的评估依赖于患

by two dermatologists without the incorporation o[[f]] objective

者的报告和两位皮肤科医生的主观评估，而没有纳入

measurement tools. Future studies with larger sample sizes

and the inclusion o[[f]] control groups are warranted to address

客观测量工具。未来的研究中，需要更大的样本量，

these limitations.

以及设置对照组来解决以上问题。

结论（Conclusion）

Conclusion

研究结果表明，使用联合三波长激光设备（

The study results demonstrate that using a combined triple-

wavelength (755 nm, 810 nm, and 1064 nm) laser device led

to signiﬁcant skin rejuvenation eﬀects without any serious

前提下，实现了显著的皮肤年轻化效果。在皮肤皱纹、

adverse events. Remarkable improvements were observed

松弛及色素沉着方面均观察到明显改善，组织学分析

in skin wrinkles, laxity, and dyspigmentation. Histologi-

cal analysis [[f]]urther revealed increased collagen and elastin

亦证实真皮层内胶原与弹性纤维束增加。基于上述发

bundles within the dermis. Based on these ﬁndings, we pro-

现，我们认为联合三波长激光是一种有效且安全的非

pose that the combined triple-wavelength laser represents an

剥脱性皮肤年轻化选择方案。

eﬀective and sa[[f]]e nonablative option for skin rejuvenation.

Supplementary In[[f]]ormation The online version contains supplemen-

作者贡献与声明（Acknowledgements & Declarations）

tary material available at https:// doi. org/ 10. 1007/ s10103- 023- 03936-6.

Acknowledgements The ﬁrst two authors, Ju Young Jo and Dong Hye

前两位作者 Ju Young Jo 和 Dong Hye Suh 对

Suh, contributed equally to this work.

本研究贡献相同。

Author contribution Hwa Jung Ryu and Dong Hye Suh contributed to

作者贡献：Hwa Jung Ryu 和 Dong Hye Suh 负责

the study’s conception and design. Data collection and analysis were

per[[f]]ormed by Ju Young Jo. The ﬁrst draft of the manuscript was writ-

研究的构思与设计。Ju Young Jo 负责数据收集与分

ten by Ju Young Jo and Dong Hye Suh. All authors commented on

previous versions o[[f]] the manuscript. All authors read and approved

析。论文初稿由 Ju Young Jo 与 Dong Hye Suh 撰

the ﬁnal manuscript.

写，所有作者均对先前版本提出意见，并最终审核通

Data availability The data that support the ﬁndings o[[f]] this study are

过定稿。

available [[f]]rom the corresponding author upon reasonable request.

数据可得性：研究数据可通过联系通讯作者并提出合

Declarations

理请求获得。

In[[f]]ormed consent Informed consent was obtained from all study par-

ticipants prior to study participation [[f]]rom each institution.

知情同意：所有研究参与者在参与前均签署了知情同

Competing interests The authors declare no competing interests.

意书。

利益冲突：作者声明不存在利益冲突。

Re[[f]]erences

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