Hua Hui, Li Min, Zhai Xiaoyu, Zhou Shu, Pan Zhonglan, Hou Zuoqiong, Zhou Bingrong
Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China.
Department of Integrated Chinese and Western Medicine, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China.
J Dermatol. 2024 Aug;51(8):1120-1124. doi: 10.1111/1346-8138.17112. Epub 2024 Jan 31.
Ultrapulse fractional CO laser is effective for acne atrophic scars. Whether this effectiveness is affected by sleep quality remains unclear. Aiming to investigate the relationship between sleep quality and postoperative effectiveness, a retrospective clinical study was conducted, enrolling 83 patients with atrophic acne scar. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire at 3 months after the end of the first treatment. The ECCA (échelle d'évaluation clinique des cicatrices d'acné) scale was used to evaluate the clinical effectiveness before and at 3 months after treatment. The patients were divided into a mild to moderate improvement group and a good to excellent improvement group, based on whether they achieved a 50% ECCA improvement rate. PSQI score was higher in the mild and moderate improvement group than in the good to excellent improvement group (7.6 ± 4.5 vs 3.8 ± 1.7, p < 0.001). Multivariate logistic regression showed that both PSQI score (odds ratio = 0.6 [95% CI = 0.5-0.8], p < 0.001) and scar type were correlated with postfractional CO laser effectiveness. Pearson correlation analysis suggested that PSQI score was negatively correlated with ECCA decline score (r = -0.6139, p < 0.0001). Receiver operating characteristic curve analysis showed that PSQI score (area under the curve = 0.759) and scar type (area under the curve = 0.737) were all closely correlated with postoperative effectiveness, without statistical difference between their accuracies (p = 0.647). Decision curve analysis demonstrated that both PSQI score and scar type correlated with postoperative effectiveness. Our results demonstrated that sleep quality correlates with the postoperative effectiveness of ultrapulse fractional CO laser in the treatment of atrophic acne scars.
超脉冲分次二氧化碳激光对痤疮萎缩性瘢痕有效。这种有效性是否受睡眠质量影响尚不清楚。为了研究睡眠质量与术后疗效之间的关系，进行了一项回顾性临床研究，纳入83例萎缩性痤疮瘢痕患者。在首次治疗结束后3个月，通过匹兹堡睡眠质量指数（PSQI）问卷测量睡眠质量。采用ECCA（痤疮瘢痕临床评估量表）量表在治疗前和治疗后3个月评估临床疗效。根据患者的ECCA改善率是否达到50%，将患者分为轻度至中度改善组和良好至优秀改善组。轻度和中度改善组的PSQI评分高于良好至优秀改善组（7.6±4.5 vs 3.8±1.7，p<0.001）。多因素逻辑回归显示，PSQI评分（比值比=0.6[95%CI=0.5-0.8]，p<0.001）和瘢痕类型均与分次二氧化碳激光治疗后的疗效相关。Pearson相关分析表明，PSQI评分与ECCA下降评分呈负相关（r=-0.6139，p<0.0001）。受试者工作特征曲线分析显示，PSQI评分（曲线下面积=0.759）和瘢痕类型（曲线下面积=0.737）均与术后疗效密切相关，其准确性无统计学差异（p=0.647）。决策曲线分析表明，PSQI评分和瘢痕类型均与术后疗效相关。我们的结果表明，睡眠质量与超脉冲分次二氧化碳激光治疗萎缩性痤疮瘢痕的术后疗效相关。
