重组牛碱性成纤维细胞生长因子在点阵CO_(2)激光治疗痤疮瘢痕术后皮肤屏障修复中的作用

Effectiveness of recombinant bovine basic fibroblast growth factor in repairing skin barrier after fractional CO_(2) laser for facial acne scars

目的 探讨重组牛碱性成纤维细胞生长因子(rb-bFGF)在点阵CO_(2)激光治疗痤疮瘢痕术后皮肤屏障修复中的作用。方法 本研究为前瞻性随机对照研究,选取2019年5月至2021年5月在首都医科大学附属北京友谊医院就诊的120例萎缩性痤疮瘢痕患者,按照随机数字表法将其分为实验组和对照组,每组60例。两组患者皮损处均进行点阵CO_(2)激光治疗,术后予透明质酸面膜湿敷,实验组激光术后每日2次,连续1周外用rb-bFGF。检测记录两组患者治疗前及治疗后1个月皮肤屏障相关指标[经皮水分丢失(TEWL)、皮肤表面酸碱值、角质层含水量、乳酸刺痛实验评分及黏脱蛋白含量]。结果 治疗后1个月,两组患者的TEWL、pH、皮损处乳酸刺激实验总评分及黏脱蛋白质含量均较治疗前降低,角质层含水量较治疗前升高,且实验组TEWL、pH、皮损处乳酸刺激实验总评分及黏脱蛋白质含量分别为(18.52±3.78) g·h^(-1)·m^(-2)、5.58±0.49、(1.64±3.08)分、(29.87±9.51)μg,均低于对照组[(22.41±4.16) g·h^(-1)·m^(-2)、5.90±0.51、(3.82±2.19)分、(35.48±10.05)μg],角质层含水量为48.45±13.68,高于对照组(40.13±14.29),差异均有统计学意义(P<0.05)。实验组色素沉着发生率为3.3%(1/30),对照组色素沉着发生率为10.0%(3/30),差异无统计学意义(P>0.05)。结论 rb-bFGF有助于点阵CO_(2)激光治疗痤疮瘢痕术后皮肤屏障的修复。

Objective To investigate the effectiveness of recombinant bovine basic fibroblast growth factor(rb-bFGF)in repairing skin barrier after fractional CO_(2) laser for acne scars.Methods This study was a prospective,randomized controlled study.A total of 120 patients with acne scars who presented at Beijing Friendship Hospital,Capital Medical University from May 2019 to May 2021 were selected and randomly divided into a treatment group and a control group with 60 cases in each group.Patients in both groups were treated with fractional CO_(2) laser,hyaluronic acid facial mask was applied after operation,but only patients in the treatment group applied topical rb-bFGF twice daily for one week after the laser operation.Indexes for skin barrier[transcutaneous water loss(TEWL),skin surface pH value,stratum corneum water content,lactic acid prick test score and mucoprotein content]were compared before treatment and one month after the treatment.Results One month after treatment,TEWL,pH,the total score of lactic acid stimulation test and the content of mucoprotein in the lesions of the two groups were lower than those before treatment,and the water content in the stratum corneum was higher than that before treatment,TEWL,pH,the total score of lactic acid stimulation test in the lesions and the content of mucoprotein in the experimental group were(18.52±3.78)g·h^(-1)·m^(-2),5.58±0.49,(1.64±3.08)points,and(29.87±9.51)μg,respectively,which were lower than those in the control group[(22.41±4.16)g·h^(-1)·m^(-2),5.90±0.51,(3.82±2.19)points,(35.48±10.05)μg],and the water content of stratum corneum was 48.45±13.68,which was higher than that in the control group(40.13±14.29),the differences were statistically significant(P<0.05).The incidence of hyperpigmentation was 3.3%(1/30)in the treatment group and 10.0%(3/30)in the control group,the difference was not statistically significant(P>0.05).Conclusion Rb-bFGF was effective in repairing skin barrier after fractional CO_(2) laser for facial acne scars.