增生性瘢痕经皮水分丢失的检测及意义研究

Assessment on the severity of epidermal barrier dysfunction in hypertrophic scar

目的:检测增生性瘢痕经皮水分丢失(TEWL);探讨表皮屏障功能障碍程度与增生性瘢痕临床特征的关系。方法:以23例患者30处增生性瘢痕为观察对象,进行瘢痕的温哥华评分和瘙痒程度分级;蒸发测定仪Dermalab检测瘢痕及其邻近正常皮肤经皮水分丢失(TEWL);数据进行统计学分析。结果:(1)增生性瘢痕TEWL(13.52±4.58)g·h-1·m-2明显高于邻近正常皮肤(6.43±3.29)g·h-1·m-2(t=5.89 P<0.01)。(2)增生性瘢痕TEWL净丧失量与瘢痕的温哥华评分呈正相关(r=0.85 P<0.01)。(3)重度瘙痒组增生性瘢痕TEWL净丧失量明显高于轻、中度瘙痒瘢痕组。结论:增生性瘢痕表皮屏障功能存在障碍,其障碍程度与临床特征相关;增生性瘢痕TEWL的净丧失量可能成为一个瘢痕评估的客观指标。

Objective： To evaluate the skin barrier function in hypertrophic scar （HS） by measuring transepidermal water loss （TEWL） and study the relationship between the severity of epidermal barrier dysfunction and clinic characteristics in HS. Method： Thirty HSs in 23 patients were assessed through Vancouver Scar Assessment Table and scar itch severity assessment. The level of TEWLs in HS and adjacent normal skin were measured with computerized evaporimetry using the DermaLabR. The difference in TEWLs between HS and adjacent normal skin was as the severity of epidermal barrier dysfunction in HS. Statistic analysis was performed. Result： （1） The level of TEWLs in HS was higher than that in adjacent normal skin. （2） A significant positive relation was reported between the difference in TEWLs and the score in Vancouver Scar Assessment in HS. （3） The difference in TEWLs in severe degree pruritus group in HS was higher than that in mild and moderate pruritus groups. Conclusion： The skin barrier function of HS was incompetent and the severity of epidermal barrier dysfunction in HS was related to its clinic characteristics. TEWLs may be as the object index to assess HS.