中重度痤疮1?064nm波长可调脉宽Nd∶YAG激光治疗后相关症状和审美评价的影响因素分析

吴轶西 曾海燕 刘超

[摘要]目的：分析中重度痤疮1 064nm波长可调脉宽Nd∶YAG激光治疗后患者出现相关症状（瘢痕遗留、色素沉着、局部红斑）的影响因素，了解人群中对中重度痤疮1 064nm波长可调脉宽Nd∶YAG激光治疗后影响审美评价的相关因素。方法：回顾性分析在笔者医院皮肤科应用1 064nm波长可调脉宽Nd∶YAG激光治疗的89例中重度痤疮患者的临床资料。选取100名外貌正常，具备完整审美能力的普通人作为评价者，根据李克特量表对患者形象进行评分。采用单因素分析和多元Logistic回归模型分析中重度痤疮激光治疗后相关症状和审美评价的影响因素。结果：单因素分析显示，年龄、性别、BMI、吸烟、皮肤类型、初发年龄、病程、发病部位、家族史、伴发病、蠕形螨、尘螨SPT、瘢痕体质均是中重度痤疮激光治疗后相关临床症状的影响因素（P<0.05）。评价者年龄、学历，患者年龄、BMI、皮肤类型、发病部位、瘢痕厚度和瘢痕柔软度是审美评价的影响因素（P<0.05）。多因素Logistic分析显示，性别、家族史、伴发病、蠕形螨及尘螨SPT是中重度痤疮激光治疗后相关症状的独立影响因素（P<0.05）。评价者年龄、患者BMI、皮肤类型和发病部位均是审美评价的独立影响因素（P<0.05）。结论：中重度痤疮1 064nm波长可调脉宽Nd∶YAG激光治疗后相关症状与性别、家族史、伴發病、蠕形螨及尘螨SPT有关。中重度痤疮1 064nm波长可调脉宽Nd∶YAG激光治疗后的审美评价与评价者年龄，患者BMI、皮肤类型和发病部位有关。

[关键词]中重度痤疮;激光治疗;审美评价;影响因素

[中图分类号]R758.73+3    [文献标志码]A    [文章编号]1008-6455（2020）04-0044-05

Abstract： Objective To analyze the influencing factors of clinical symptoms （scarring， pigmentation and local erythema） in patients with moderate and severe acne after 1 064nm controllable pulse width Nd：YAG laser treatment and understand the related factors of aesthetic evaluation after 1 064nm controllable pulse width Nd：YAG laser treatment. Methods The clinical data of 89 patients with moderate to severe acne treated with 1 064nm controllable pulse width Nd：YAG in the dermatology department of our hospital were retrospectively analyzed. 100 ordinary people with normal appearance and complete aesthetic ability were selected as evaluators， and the images of patients were rated according to Likert Scale. The univariate analysis and multivariate Logistic regression model were used to analyze the influencing factors for clinical symptoms and aesthetic evaluation of moderate and severe acne after laser treatment. Results  The univariate analysis showed that age， gender， body mass index（BMI）， smoking， skin type， onset age， course of disease， location of the disease， family history， concomitant disease， demodex， dust mite SPT and scar constitution were the influencing factors of clinical symptoms （P<0.05）. The education and age of the evaluator， the age of patients， BMI， skin type， location of the disease， scar thickness and scar softness were the influencing factors of aesthetic evaluation （P<0.05）. The multivariate Logistic analysis showed that gender， family history， concomitant disease， demodex and dust mite SPT were the independent influencing factors of clinical symptoms（P<0.05）. The age of the evaluator， BMI of the patient， skin type and location of the disease were the independent influencing factors of aesthetic evaluation（P<0.05）. Conclusion  The clinical symptoms of moderate and severe acne after 1064nm controllable pulse width Nd：YAG laser treatment are related to gender， family history， concomitant disease， demodex and dust mite SPT. The aesthetic evaluation of moderate and severe acne after 1 064nm controllable pulse width Nd：YAG laser treatment are related to age of evaluator， BMI of patient， skin type and location of the disease.

Key words： moderate and severe acne; laser therapy; aesthetic evaluation; influencing factors

隨着生活节奏的加快和生活方式的改变，人们的精神压力随之增大，导致生活作息紊乱、心理负担沉重，患有痤疮的人数日益增多[1]。痤疮作为临床上一种常见的慢性炎症性皮肤病，为多因素综合作用所致，该病患病率较高，且病程长、易复发，往往多发于青少年。一旦患者出现痤疮，通常会累及皮脂腺和毛囊，以瘢痕、丘疹、粉刺及脓疱等多形态皮肤损害为主要特征，影响患者的容貌外观，使患者产生自卑、焦虑的心理，进而影响患者的日常交际和生活质量[2-3]。近年来，临床上治疗痤疮的方法各式各样，但针对于中重度痤疮患者，采用常规药物治疗起效慢且少数患者可存在耐药性，难以达到理想的治疗效果，因此，对患者的自信心具有长期的负面影响[4-5]。……