Department of Anesthesiology and Intensive Care, Östersund Hospital, Research and Development Unit, Jämtland County Council, Östersund, Sweden.
Burns. 2012 Nov;38(7):1005-9. doi: 10.1016/j.burns.2012.02.014. Epub 2012 May 29.
The increased vascular permeability seen after burn contribute to morbidity and mortality as it interferes with organ function and the healing process. Large efforts have been made to explore underlying pathophysiological mechanisms that generate increased vascular permeability after burns. Many different substances have been proposed as mediators of which histamine, serotonin and oxygen radicals are claimed most important. However, no specific blocker has convincingly been shown to be clinically effective. Early work has claimed increased histamine plasma-concentrations in humans after burn and data from animal models pointed at histamine as an important mediator. Modern human clinical studies investigating the role of histamine as a mediator of the generalized post burn increase in vascular permeability are lacking.
We examined histamine turnover by measuring the urinary excretion of histamine and methyl histamine for 48 h after burns in 8 patients (mean total burn surface area 24%).
Over time, in this time frame and compared to healthy controls we found a small increase in the excretion of histamine, but no increase of its metabolite methylhistamine.
Our findings do not support that histamine is an important mediator of the increased systemic vascular permeability seen after burn.
烧伤后血管通透性增加会导致发病率和死亡率升高,因为它会干扰器官功能和愈合过程。人们已经做出了巨大的努力来探索烧伤后血管通透性增加的潜在病理生理机制。已经提出了许多不同的物质作为介质,其中组胺、血清素和氧自由基被认为是最重要的。然而,没有令人信服的证据表明任何特定的阻滞剂在临床上是有效的。早期的工作声称烧伤后人体血浆中的组胺浓度增加,动物模型的数据表明组胺是一种重要的介质。缺乏关于组胺作为烧伤后全身性血管通透性增加的介导物的作用的现代人类临床研究。
我们通过测量 8 名烧伤患者(烧伤总面积平均为 24%)烧伤后 48 小时内尿中组胺和甲基组胺的排泄来检查组胺的转化。
在这段时间内,与健康对照组相比,我们发现组胺的排泄量略有增加,但没有发现其代谢产物甲基组胺的增加。
我们的发现不支持组胺是烧伤后全身性血管通透性增加的重要介质。