Joint Efficacy of Fractional CO2 Laser and Platelet-Rich Plasma in Treating Depressed Acne Scars & Construction of Prediction Model
Objective To explore the joint efficacy of fractional CO2 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％)of adverse reaction in the FCL+PRP group was smallerthan that(31.7％)in the FCL group(P＜0.05).According to the clinical efficacy,the patients in the FCL+PRP group were divided into an effective group(n=34)and ineffective group(n=26).The results of univariate and binary logistic regression analysis showed that disease course,ECCA score before treatment,Hamilton anxiety scale(HAMA)score,Hamilton depression scale(HAMD)score and complication with other skin diseases were independent risk factors affecting the curative efficacy(P＜0.05).The prediction model was expresses as below:Logit(P)=0.637 × disease course+1.091×ECCA score before treatment+0.540×HAMA score+0.208×HAMD score+2.275×complicated with other skin diseases-9.955.The result of ROC curve analysis showed that,for the prediction model,the AUC was 0.745,sensitivity was 79.4％and specificity was 76.9％.The results of Hosmer-Lemeshow test showed that the prediction model had a good fit(x2=10.444,P=0.235).Conclusions The combination of fractional CO2 laser with platelet-rich plasma will improve the therapeutic effect of depressed acne scars,ease treatment pain,shorten swelling time and eschar formation and removal time and reduce the incidence of adverse reaction.The disease course,severity of scars before treatment,mental state and complication with other skin diseases are the independent risk factors of efficacy.The construction of a prediction model is more conducive to the evaluation of the efficacy.
LaserPlatelet-rich plasmaDepressed acne scarEfficacyInfluencing factorsPrediction model
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万方数据
