rhEGF 联合点阵激光对痤疮疤痕患者皮肤屏障功能及TLR2 水平的影响

Effect of rhEGF combined with lattice laser on skin barrier function and TLR2 level in patients with acne scars

摘要:

目的 探讨基因重组人表皮生长因子（rhEGF）联合点阵激光对痤疮疤痕患者皮肤屏障功能及Toll 样受体2（TLR2）的影响。方法 选取2014 年1 月-2015 年12 月之间收入该院的60 例痤疮疤痕患者为研究对象，根据随机数字法分为对照组和研究组，每组各30例。对照组患者给予点阵超脉冲CO2 激光治疗，研究组患者在点阵超脉冲CO2 激光治疗后外用rhEGF 凝胶。比较两组患者的疗效、外周血CD14+ 单核细胞TLR2 表达率及皮肤屏障功能。结果 两组患者的治疗总有效率比较，差异有统计学意义（P <0.05），研究组高于对照组（93.33 % vs 70.00 %）。治疗后，两组患者的经皮水份丢失（TEWL）、皮肤红斑情况（a 值）均较治疗前降低，差异有统计学意义（P <0.05），研究组低于对照组；两组患者的pH 值较治疗前均降低，差异有统计学意义（P <0.05），研究组低于对照组；两组患者的角质层含水量较治疗前均升高，差异有统计学意义（P <0.05），研究组高于对照组。治疗后，两组患者的乳酸刺激实验总分、粘脱蛋白质含量较治疗前均降低，差异有统计学意义（P <0.05），研究组低于对照组。治疗后，两组患者的TLR2 表达率较治疗前均降低，研究组患者低于对照组。研究组患者的瘢痕增生、色素沉着及持久性潮红的发生率低于对照组。结论 rhEGF 联合点阵激光对治疗痤疮疤痕具有良好的治疗效果，能够降低TLR2 表达水平，改善皮肤屏障功能，减少不良反应，值得临床推广应用。

Abstract:

Objective To discuss the effect of recombinant human epidermal growth factor (rhEGF) combined with lattice laser on skin barrier function and Toll-like receptor 2 (TLR2) level in patients with acne scars. Methods From January 2014 to December 2015, 60 patients with acne scars were selected for this study in our hospital and the patients were randomly divided into study group (30 cases) and control group (30 cases). The control group was given lattice ultra pulse CO2 laser treatment, the study group received rhEGF gel for external use after lattice ultra pulse CO2 laser treatment. The curative effect, TLR2 expression rate of CD14+ monocytes in peripheral blood and skin barrier function of the patients were compared. Results The total effective rate of the study group was significantly higher than that of the control group (93.33% vs. 70.00%, P < 0.05). After treatment, the TEWL and a value of the two groups were reduced, more significantly in the study group than in the control group (P < 0.05);the pH value was reduced in the two groups, was lower in the study group than in the control group (P > 0.05); the corneous layer water content of the two groups was increased and significantly higher in the study group than in the control group (P < 0.05). After treatment, the total score of lactic acid stimulation test and protein content of the two groups were decreased, more obviously in the study group than in the control group (P < 0.05). After treatment,the TLR2 expression rate of the two groups was reduced, and was significantly lower in the study group than in the control group (P < 0.05). The incidences of scar hyperplasia, pigmentation and persistent flush of the study group were significantly lower than those of the control group (P < 0.05). Conclusions rhEGF combined with lattice laser is effective for acne scars. It can reduce the expression of TLR2, improve skin barrier function, lower the incidences of adverse reactions, is worthy of application.