摘要
目的探讨CO_(2)点阵激光(fractional CO_(2)laser,FCL)联合富血小板血浆(platelet-rich plasma,PRP)治疗痤疮凹陷性瘢痕的疗效,分析其影响因素并构建预测模型。方法选取2023年1月至2024年1月,痤疮凹陷性瘢痕患者120例,采用随机数字表法分为FCL组和FCL+PRP组,每组患者各60例。两组患者均采用FCL治疗,能量70~120 mJ,点阵间距0.6~1.2 mm,共治疗3次,每次治疗间隔1个月。FCL组患者治疗后即刻外敷生理盐水;FCL+PRP组即刻外敷PRP。采用视觉模拟(visual analogue scale,VAS)评分评估患者每次治疗中疼痛程度,记录红肿时间、结痂时间、脱痂时间。采用痤疮瘢痕权重评分表(echelle d'évaluation clinique des cicatrices d'acné,ECCA)评估治疗前、每次治疗后1个月患者痤疮瘢痕严重程度;第3次治疗后1个月采用ECCA下降指数(symptom score reduce index,SSRI)判定凹陷性瘢痕的临床疗效。记录治疗期间及治疗后两组患者不良反应发生率。根据治疗效果将FCL+PRP组患者再分为有效组和无效组,利用单因素分析和二元Logistic回归分析FCL联合PRP治疗痤疮凹陷性瘢痕疗效的影响因素并构建预测模型。采用ROC曲线和Hosmer-Lemeshow检验验证模型的预测效能及拟合优度。结果第3次治疗后1个月,FCL+PRP组总有效率(56.6%)高于FCL组(38.4%)(P<0.05)。FCL+PRP组ECCA评分、VAS评分、红肿时间、结痂时间和脱痂时间均低于FCL组(P<0.05)。FCL+PRP组不良反应发生率(10.0%)低于FCL组(31.7%)(P<0.05)。根据治疗效果将FCL+PRP组患者分为有效组(n=34)及无效组(n=26),单因素和二元Logistic回归分析显示病程、治疗前ECCA评分、HAMA评分、HAMD评分、合并其他皮肤疾病是影响疗效的独立危险因素(P<0.05)。预测模型方程为Logit(P)=0.637×病程+1.091×治疗前ECCA评分+0.54×HAMA评分+0.208×HAMD评分+2.275×合并其他皮肤疾病-19.955。ROC曲线结果显示该模型预测FCL+PRP疗效的AUC为0.745,敏感度为79.4%,特异度为76
Objective To explore the joint efficacy of fractional CO_(2)laser(FCL)and platelet-rich plasma(PRP)in treating depressed acne scars and the influencing factors concerned and construct a prediction model.Methods Totally 120 patients with depressed acne scars treated between Jan.2023 and Jan.2024 were selected and divided randomly into a FCL group(n=60)and a FCL+PRP group(n=60).All the patients were given FCL treatment(energy:20-120 mJ and spot density:0.6-1.2 mm)once every month,which was carried out 3 times in total.Upon the FCL,while the patients in the FCL group being applied normal saline,those in the FCL+PRP group were given PRP.Visual analogue scale(VAS)score was used to evaluate the patients’pain levels during each treatment,and the swelling,eschar formation and eschar removal time were recorded.Echelled'Évaluationclinique des cicatrices d'acné(ECCA)was used to evaluate the severity of patients'acne scars before and 1 month after each treatment respectively.ECCA symptom score reduce index(SSRI)was used to determine the clinical efficacy of depressed acne scars 1 month after the third treatment.The incidence of adverse reaction in two groups of patients during and after the treatment was also recorded.The patients in the FCL+PRP group were divided into an effective group and ineffective group according to the clinical efficacy.Univariate and binary logistic regression analysis were used to analyze the influencing factors of the combined efficacy of FCL+PRP in treating depressed acne scars.A prediction model was constructed.ROC curve and Hosmer-Lemeshow test were used to analyze the predictive value and goodness-of-fit of the prediction model.Results One month after the third treatment,the total effective rate(56.6%)in the FCL+PRP group was higher than that(38.4%)in the FCL group(P<0.05).The ECCA and VAS score were lower in the FCL+PRP group than in the FCL group(P<0.05),and the swelling,eschar formation and eschar removal time shorter in the FCL+PRP group than in the FCL group(P<0.05).The incidence(10.0%
作者
张秋华
张永翠
李凤霞
刘昕
ZHANG Qiuhua;ZHNAG Yongcui;LI Fengxia;LIUXin(Department of Dermatology,Heze Hospital of Traditional Chinese Medicine,Heze 274009,China;Department of Dermatology,Heze Municipal Hospital)
出处
《中国激光医学杂志》
CAS
2024年第4期187-194,共8页
Chinese Journal of Laser Medicine & Surgery
关键词
激光
富血小板血浆
痤疮凹陷性瘢痕
疗效
影响因素
预测模型
Laser
Platelet-rich plasma
Depressed acne scar
Efficacy
Influencing factors
Prediction model
