A型肉毒毒素治疗痤疮性瘢痕的远期随访观察

摘要

Objective To investigate both the short-and long-term effect of botulinum toxin type A (BTXA) injection on hypertrophic ache scar.Methods A total of 26 patients with acne scar received BTXA injection of within 100 units.The effect was evaluated using the ECCA grading scale before treatment and during clinic re-visit,which based on history of acne scar and number of scar area.The short-and long-term effect was recorded.The average follow-up period was 39.23 months.All results were evaluated by SPSS 21.0.ANOVA was used to evaluate average value and standard deviation of ECCA grading scale.Kaplan-Meier survival curve was used to evaluate relapse-free period,and Pearson test was used to detect relevant factors of relapse-free period.Results The BTXA injection showed significant positive long-term effect on inflammatory or hypertrophic acne scar.The average ECCA grading scale was 103.460 ±36.872 before treatment,79.620 ±37.146 at 6 months after treatment,63.160 ±24.049 at 12 months after treatment,47.500 ±4.629 at 18 months after treatment,and 50.000 ± 0.000 at 24 months after treatment,showing significant differences between any of two groups (P ＜ 0.01).Average relapsefree period was 28.354 ± 1.775 months.Relapse-free period was related to ECCA grading scale pre treatment and injection times (P ＜ 0.01);meanwhile,dose of BTXA and length of disease all had statistical significance (P ＜ 0.05);however,age and gender had no statistical significance (P ＞ 0.05).Conclusions The BTXA injection can relieve inflammation and improve scar texture in patients with hypertrophic acne scar in both the short-and long-term follow-up.%目的 观察临床A型肉毒毒素注射治疗痤疮性瘢痕的近、远期效果.方法 采用A型肉毒毒素注射治疗痤疮性瘢痕患者26例,肉毒毒素用量按部位计算,全面部用量控制在100 U以内;注射前、后痤疮性瘢痕严重程度根据ECCA评分标准,以病史长短及瘢痕个数为依据计分;停药后继续随访记录无复发期,平均治疗、随访时间为39.23个月.采用SPSS 21.0软件进行统计分析,ANOVA统计治疗前、后不同时期ECCA评分的均值及标准差,并检测各组间的差异;停止治疗后无复发期以Kaplan-Meier生存曲线分析,并用Pearson检测无复发期与各相关因素的相关性.结果 A型肉毒毒素对炎性增生性痤疮瘢痕有明显治疗作用,治疗前和治疗后6、12、18、24个月的ECCA评分结果分别为:103.460±36.872、79.620±37.146、63.160±24.049、47.500±4.629、50.000±0.000,治疗前、后比较差异有统计学意义(P＜0.0l);停止治疗后无复发期平均达(28.354±1.775)个月;无复发期与治疗前ECCA评分、注射治疗次数的相关性有统计学意义(P＜0.01),与肉毒毒素用量、病程长短的相关性有统计学意义(P＜0.05),与年龄、性别的相关性无统计学意义(P＞0.05).结论 A型肉毒毒素可以较好地治疗炎性增生性痤疮瘢痕,远期效果良好.