铒激光与E光联合重组人源Ⅲ型胶原蛋白治疗面部痤疮凹陷性瘢痕的疗效及对p38MAPK通路蛋白的影响  

Efficacy of Erbium Laser and E-light Combined with Recombinant Human Collagen Type Ⅲ in the Treatment of Depressed Facial Acne Scars and p38MAPK Pathway Protein

作　　者：陈辛亮[1] 李文志[1] 董永 CHEN Xin-liang;LI Wen-zhi;DONG Yong(Department of Plastic Surgery,Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院整形激光美容科,北京100029

出　　处：《中国美容医学》2021年第6期30-35,共6页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨铒激光与E光联合重组人源Ⅲ型胶原蛋白治疗面部痤疮凹陷性瘢痕的疗效及对痤疮瘢痕权重评分(Echelle d'Evaluation Clinique des Cicatrices d'acne,ECCA)、p38丝裂原活化蛋白激酶(P38 mitogen activated protein kinase,p38MAPK)通路蛋白的影响。方法:选取笔者医院2018年1月-2019年12月面部痤疮凹陷性瘢痕患者195例,按照随机数字法分为3组,各65例。对照1组给予E光联合重组人源Ⅲ型胶原蛋白,对照2组给予铒激光联合重组人源Ⅲ型胶原蛋白,研究组给予铒激光与E光联合重组人源Ⅲ型胶原蛋白。比较三组治疗效果、治疗前后温哥华瘢痕量表(Vancouver scar scale,VSS)变化情况、ECCA评分、视觉模拟评分(Visual analogue scale,VAS)、血清p38MAPK通路蛋白(ERK1、ERK2、MEK1、MEK2)、炎性因子[肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)]及患者满意度。结果:研究组总有效率(95.38%)高于对照1组(81.54%)、对照2组(84.62%),差异有统计学意义(P<0.05)。治疗结束后三组瘢痕厚度、血管分布、色泽、柔软度评分、ECCA、VAS评分低于治疗前,研究组低于对照1组、对照2组,差异有统计学意义(P<0.05)。治疗结束后三组血清MEK1、MEK2、ERK1、ERK2、TNF-α、IL-6、CRP低于治疗前,研究组低于对照1组、对照2组,差异有统计学意义(P<0.05)。研究组患者满意度(93.85%)高于对照1组(80.00%)、对照2组(80.00%),差异有统计学意义(P<0.05)。结论:联合采取铒激光、E光、重组人源Ⅲ型胶原蛋白治疗面部痤疮凹陷性瘢痕效果显著,且患者满意度较高。Objective To investigate the effect of erbium laser and E-light combined with recombinant human collagen typeⅢin the treatment of depressed facial acne scars and the effect on Echelle d’Evaluation Clinique des Cicatrices d’acne(ECCA)and P38 mitogen activated protein kinase(p38MAPK)pathway protein.Methods From January 2018 to December 2019,195 patients with depressed facial acne scars in our hospital were selected and divided into 3 groups according to the random number method,with 65 cases in each group.The control group 1 was given E-light combined with recombinant human collagen typeⅢ,the control group 2 was given erbium laser combined with recombinant human collagen typeⅢ,and the study group was given erbium laser and E light combined with recombinant human collagen typeⅢ.The treatment effects,changes of Vancouver scar scale(VSS),ECCA score,Visual analogue scale(VAS)score,and serum p38MAPK pathway proteins(ERK1,ERK2,MEK1,MEK2),inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]before and after treatment and the degree of patient satisfaction were compared among the three groups.Results The total effective rate(95.38%)of the study group was higher than that of the control group 1(81.54%)and the control group 2(84.62%),the differences were statistically significant(P<0.05).After the treatment,the thickness,blood vessel distribution,color,softness score,ECCA,and VAS scores of the scars in the three groups were lower than before the treatment,and the study group were lower than the control group 1 and the control group 2(P<0.05).After treatment,serum MEK1,MEK2,ERK1,ERK2,TNF-α,IL-6,CRP in the three groups were lower than before treatment,and the study group were lower than the control group 1 and thecontrol group 2(P<0.05).The satisfaction degree of patients in the study group(93.85%)was higher than that of the control group 1(80.00%)and the control group 2(80.00%),the differences were statistically significant(P<0.05).Conclusion The combined use of erbium

关 键 词：铒激光 E光 重组人源Ⅲ型胶原蛋白 痤疮 凹陷性瘢痕 面部 ECCA评分 p38MAPK通路蛋白 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]