CO_2点阵激光联合紫草治疗增生性瘢痕临床疗效及对血清中VEGF的影响

Clinical Effectiveness and Effects on the Serum Levels of VEGF of Fractional CO_2 Laser and Lithospermum in the Treatment of the Hypertrophic Scar

目的探讨CO_2点阵激光联合紫草治疗增生性瘢痕的临床疗效及对患者血清中血管内皮生长因子(VEGF)的影响。方法将120例增生性瘢痕患者分为对照组(紫草治疗组),观察组(CO_2点阵激光联合紫草治疗组),比较两组患者治疗前后温哥华瘢痕量表(VSS)变化情况及观察两组患者的临床疗效;采用双抗体夹心酶联免疫吸附法(ELISA)检测健康对照组及各治疗组研究对象标本血清中VEGF含量。结果治疗后,对照组及观察组VSS量表各评分均显著低于治疗前,且观察组降低更明显,差异均有统计学意义(P<0.05)。观察组的有效率(60.00%)高于对照组(48.33%),差异无统计学意义(P>0.05),但观察组的临床效果改善明显。治疗前,对照组、观察组患者血清VEGF浓度均显著高于健康对照组(P<0.001);治疗后,对照组及观察组患者的血清VEGF浓度均显著低于治疗前,且观察组显著低于对照组(P<0.001)。结论 CO_2点阵激光联合紫草治疗增生性瘢痕患者安全有效,可有效降低增生性瘢痕患者血清中VEGF含量。

Objective The aim of this study was to evaluate the clinical effect of fractional CO2 laser and lithospermum on hypertrophic scar and VEGF expression in hypertrophic scar.Methods One hundred and twenty patients with hyperplastic scar were divided into the control group treated with lithospermum and the observation group treated with the fractional CO2 laser and lithospermum.Vancouver Scar Scale（VSS）was used to assess the patients before and after the treatment.At the same time, we determined the clinical effects of patients with hyperplastic scar.We used the double antibody sandwich enzyme-linked immunosorbent（ELISA）to detect the level of VEGF in the patients and controls.Results There was statistically significant difference in VSS before and after the treatment in the control group and observation group.After the treatment, the VSS score in control and observation group were significantly lower than before the treatment, especially in the observation group（P〈0.05）. The effective rate of control and observation group were 48.33% and 60.00% respectively.The effective rate of observation group was higher than the control group.There was no statistical significance between the two groups（P〉0.05）.Before the treatment, the expression of VEGF in control and observation group was significantly higher than the healthy controls（P〈0.001）.After treatment, the serum concentration of VEGF in the control and observation group was significantly lower than before treatment, particularly in the observation group（P〈0.001）.Conclusion It is a safe and effective therapy to hypertrophic scar with fractional CO2 laser and lithospermum.The expression of VEGF in the patients with hypertrophic scar was significantly decreased after treatment.