脉冲染料激光联合二氧化碳点阵激光对兔耳增生性瘢痕的影响

Effect of carbon dioxide fractional laser combined with pulsed dye laser on hypertrophic scar in rabbit ears

目的:评价脉冲染料激光(PDL,585 nm)联合二氧化碳点阵激光(CO 2FL,10600 nm)对兔耳增生性瘢痕的影响。方法:对20只雌性新西兰大耳兔进行造模,每只兔耳共有8处瘢痕,其中2处为对照,2处给予脉冲染料激光、2处给予二氧化碳点阵激光、2处给予联合治疗,两周治疗1次,共治疗2次。两组于治疗14天和28天后,检测瘢痕的瘢痕增生指数(SEI)、瘢痕内成纤维细胞密度、胶原纤维面积、细胞凋亡以及TGF-β1、Smad3表达的水平变化。结果:联合治疗组SEI指数、成纤维密度指标、胶原纤维面积、TGF-β1、Smad3表达明显低于脉冲染料激光组、二氧化碳点阵激光组及对照组(均P<0.05),细胞凋亡率高于上述3组(均P<0.05)。结论:PDL联合CO 2FL激光对增生性瘢痕的干预效果优于脉冲染料激光和二氧化碳点阵激光单独治疗。

Objective:To assess the effect of carbon dioxide fractional laser(CO 2FL,10600nm),combined with pulsed dye laser(PDL,585nm)on hypertrophic scars.Methods:The hypertrophic scars model was established in 20 New Zealand rabbits.There were 8 hypertrophic scars in every ear of the rabbits,including 2 scars treated as controls,2 treated with CO 2FL,2 treated with PDL,and 2 treated with PDL combined with CO 2FL,once every 2 weeks for 2 times.The Scar Elevation Index(SEI),collagen I and collagen III,apoptotic fibroblast cells,and the TGF-β1 and Smad3 levels were detected after treated for 14 days and 28 days.Results:The SEI,fibroblast density index,collagen fiber area,and the level of TGF-β1 and Smad3 in the PDL combined with CO 2FL group were lower than those in the control group,PDL group and CO 2FL group,with significant differences(P s<0.05).The cell apoptosis rate was higher in the PDL combined with CO 2FL group than in other groups,with significant differences(P s<0.01).Conclusion:PDL combined with CO 2FL laser in the treatment of hypertrophic scar is more effective than PDL or CO 2FL laser alone.