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烧伤后维生素D缺乏与增生性瘢痕生物力学特性之间的关联

The Association Between Postburn Vitamin D Deficiency and the Biomechanical Properties of Hypertrophic Scars.

作者信息

Cho Yoon Soo, Seo Cheong Hoon, Joo So Young, Song Jimin, Cha Eunsil, Ohn Suk Hoon

机构信息

Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, Seoul.

Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.

出版信息

J Burn Care Res. 2019 Apr 26;40(3):274-280. doi: 10.1093/jbcr/irz028.

Abstract

Fibroblasts, keratinocytes, mast cells, and other cells participate in hypertrophic scar formation and express the vitamin D receptor. We investigated the association between vitamin D deficiency and the biomechanical properties of hypertrophic burn scars. This cross-sectional study analyzed 486 participants enrolled from May 1, 2013 to April 30, 2017. When complete wound healing was agreed with by the two opinions, blood sampling and scar evaluation were performed. The values of melanin and erythema, trans-epidermal water loss (TEWL), and scar distensibility and elasticity were measured using pigment- and TEWL-measuring devices and a suction skin elasticity meter. 25(OH) vitamin D deficiency was defined as plasma level of <20 ng/ml. The vitamin D-deficient patients had significantly higher mean values of scar melanin and TEWL (P = .032, P = .007), whereas scar erythema level was similar. They also showed significantly lower values of Uf (final distensibility; P < .001), Ua/Uf (gross elasticity; P < .001) and Ur/Uf (biological elasticity; P = .014), and higher value of Uv/Ue (viscoelasticity or potency against interstitial fluid shift; P = .016). In multiple linear regression analysis, Uf, Ua/Uf, Uv/Ue, and Ur/Uf were significantly affected by 25(OH)-vitamin D level in deficient patients (Uf, P = .017; Ua/Uf, P = .045; Uv/Ue, P = .024; Ur/Uf, P = .021). Our results demonstrated that vitamin D deficiency was significantly related to increased pigmentation, decreased skin barrier function, low scar distensibility and elasticity, and slow interstitial fluid movement in burn patients.

摘要

成纤维细胞、角质形成细胞、肥大细胞和其他细胞参与增生性瘢痕形成并表达维生素D受体。我们研究了维生素D缺乏与烧伤增生性瘢痕生物力学特性之间的关联。这项横断面研究分析了2013年5月1日至2017年4月30日期间纳入的486名参与者。当两位医生均认可伤口完全愈合时,进行血液采样和瘢痕评估。使用色素测量仪和经表皮水分流失(TEWL)测量仪以及皮肤吸力弹性仪测量黑色素和红斑值、TEWL、瘢痕延展性和弹性。25(OH)维生素D缺乏定义为血浆水平<20 ng/ml。维生素D缺乏患者的瘢痕黑色素和TEWL平均值显著更高(P = .032,P = .007),而瘢痕红斑水平相似。他们的Uf(最终延展性;P < .001)、Ua/Uf(总弹性;P < .001)和Ur/Uf(生物弹性;P = .014)值也显著更低,Uv/Ue(粘弹性或抗组织间隙液转移能力;P = .016)值更高。在多元线性回归分析中,Uf、Ua/Uf、Uv/Ue和Ur/Uf在缺乏维生素D的患者中受25(OH)-维生素D水平的显著影响(Uf,P = .017;Ua/Uf,P = .045;Uv/Ue,P = .024;Ur/Uf,P = .021)。我们的结果表明,维生素D缺乏与烧伤患者色素沉着增加、皮肤屏障功能降低、瘢痕延展性和弹性降低以及组织间隙液移动缓慢显著相关。

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