人增生性瘢痕瘙痒症状与局部5-羟色胺的含量

Relationship between 5-hydroxytryptamine content and pruritus in patients with hyperplastic scar

目的:测定不同程度瘙痒的瘢痕组织和正常皮肤中5-羟色胺水平,评价5-羟色胺在增生性瘢痕瘙痒症状中的作用。方法:实验于2002-09/2004-12在中山大学附属第一医院烧伤科和外科实验室完成。取瘢痕和正常皮肤标本89例(每例患者均有1处瘢痕)。男48例,女41例。其中增生性瘢痕68例,非增生性瘢痕21例。两组病例中各取8例正常皮肤组织作为对照。应用荧光法测定不同程度瘙痒的瘢痕组织和正常皮肤中5-羟色胺水平,并分析其与瘢痕瘙痒程度(分级:0级:无瘙痒感;1级:瘙痒很轻,轻抓可缓解;2级:瘙痒令人烦恼,需较强烈的搔抓方可缓解,可以耐受;3级:瘙痒影响工作或不能耐受,需长时间不断搔抓,无语言表达能力的儿童表现为吵闹不安)的关系。结果:①5-羟色胺含量:增生性瘢痕明显高于非增生性瘢痕和正常皮肤犤(467.82±38.92),(382.79±34.36),(378.65±29.98)ng/g,P<0.01犦。②不同瘙痒级别的瘢痕组织中5-羟色胺含量:3级和2级显著高于10级和0级犤(479.32±40.16),(470.33±39.12),(393.37±37.56),(381.25±32.09)ng/g,P<0.01犦。③瘢痕部位瘙痒程度与局部5-羟色胺含量的关系呈正相关(r=0.918,P<0.01)。结论:瘢痕中、重度瘙痒组织中5-羟色胺含量显著高于轻度瘙痒和无瘙痒组织;增生性瘢痕组织中的5-羟色胺含量显著高于非增生性瘢痕和正常皮肤。提示5-羟色胺在瘢痕的中、重度瘙痒症状中起重要作用。

AIM： To determine the 5-hydroxytryptamine （5-HT） levels in scar tissues with different extent itching and normal skin tissues, and evaluate the effect of 5-HT in scar tissues on the pruritus of patients with hyperplastic METHODS： The experiment was conducted in the Laboratories of Burn and Surgery Departments, the First Affiliated Hospital of Sun Yat-sen University from September 2002 to December 2004. Eighty-nine cases of scar and normal skin samples were obtained from 48 male and 41 female patients, including 68 cases of hyperplastic scar and 21 of non-hyperplastic scar. Each 8 cases of normal skin samples were selected as controls in the two groups. Fluorometric method was conducted to examine the contents of 5-HT in scar tissues and normal skin tissues. The relationships between the data obtained and clinical itching complaints were analyzed. RESULTS： ①Content of 5-HT： The contents of 5-HT in hypertrophic scars were significant higher than those in normal skins and non-hypertrophic scars[（467.82±38.92）, （382.79±34.36）, （378.65±29.98） ng/g, P 〈 0.01].② Content of 5-HT in scar tissues with different extent itching： 5-HT contents in scars with itching ranking as 3 [（479.32±40.16） ng/g] and 2 [（470.33±39.12）ng/g]were significant higher than those in scars with itching ranking as 1 [（393.37±37.56）ng/g] and 0[ （381.25±32.09） ng/g].③The extent of pruritus was correlated positively with 5-HT content （ r = 0.918, P 〈 0.01） CONCLUSION： 5-HT contents in scars with moderate or severe itching are higher than those in scars with mild or no itching. And 5-HT contents in hyperplastic scar are dramatically higher than those in non-hyperplastic scar and normal skin tissues. It is indicated that 5-HT plays an important role in moderate or severe itching of scar.