Imaging hemoglobin oxygen saturation in sickle cell disease patients using noninvasive visible reflectance hyperspectral techniques: effects of nitric oxide.
Imaging hemoglobin oxygen saturation in sickle cell disease patients using noninvasive visible reflectance hyperspectral techniques: effects of nitric oxide.
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DOI：
10.1152/ajpheart.00243.2003
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发表时间：
2003-09
期刊：
影响因子：
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通讯作者：
K. Zuzak;M. Gladwin;R. Cannon;I. W. Levin
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文献类型：
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作者：
K. Zuzak;M. Gladwin;R. Cannon;I. W. Levin
镰状细胞病的特征是微血管闭塞和溶血性贫血，这是损害组织氧输送的因素。我们使用可见光反射高光谱成像定量皮肤组织血红蛋白氧饱和度（HbO 2），并确定是否在一氧化氮（NO）刺激或气体管理（治疗这种疾病的建议）改善皮肤组织氧饱和度在5例镰状细胞病患者的血流变化。与6名健康的非裔美国人受试者相比，镰状细胞病患者前臂血流量较高（7.4 +/- 1.8 vs. 3.2 +/- 0.4 ml.min-1.100 ml组织-1，P = 0.037），但皮肤HbO 2百分比显著降低（61.0 +/- 0.2 vs. 77.5 +/-0.2%，P < 0.001）。给予乙酰胆碱使患者的血流量增加了15.1 +/- 3.8 ml·min-1·100 ml组织-1，皮肤HbO 2百分比增加了4.1 +/- 0.3%（与基线值相比，分别为P = 0.02，P < 0.001）。直接NO供体硝普钠使血流量增加3.9 +/- 1.1 ml/min，皮肤HbO 2百分比增加2.9 +/- 0.3%（分别为P = 0.02，P < 0.001）。吸入NO对前臂血流量无明显影响，但使皮肤HbO 2含量增加2.3 ± 0.3%（P < 0.001）。皮肤组织氧饱和度与血流量呈指数相关（R = 0.97，P < 0.001），提示高血流量时皮肤组织氧饱和度有限。因此，对于乙酰胆碱输注导致血流量比健康休息的非裔美国人受试者高7倍的患者，患者仍然表现出较低的皮肤HbO 2百分比（65.2 +/-0.2 vs. 77.5 +/-0.2%，P < 0.001）。可见光反射高光谱成像表明，无论是刺激或管理的NO-3或通过气体吸入改善，但不正常，皮肤组织的血氧饱和度在镰状细胞病患者。
Sickle cell disease is characterized by microvascular occlusion and hemolytic anemia, factors that impair tissue oxygen delivery. We use visible reflectance hyperspectral imaging to quantitate skin tissue hemoglobin oxygen saturation (HbO2) and to determine whether changes in blood flow during nitric oxide (NO) stimulation or gas administration (therapies proposed for this disease) improve skin tissue oxygen saturation in five patients with sickle cell disease. Compared with six healthy African-American subjects, sickle cell patients exhibited higher forearm blood flows (7.4 +/- 1.8 vs. 3.2 +/- 0.4 ml.min-1.100 ml tissue-1, P = 0.037) but significantly reduced percentages of skin HbO2 (61.0 +/- 0.2 vs. 77.5 +/- 0.2%, P < 0.001). Administration of acetylcholine to patients increased blood flow by 15.1 +/- 3.8 ml.min-1.100 ml tissue-1 and the percentage of skin HbO2 by 4.1 +/- 0.3% (P = 0.02, P < 0.001, respectively, from baseline values). Sodium nitroprusside, a direct NO donor, increased blood flow by 3.9 +/- 1.1 ml/min and the percentage of skin HbO2 by 2.9 +/- 0.3% (P = 0.02, P < 0.001, respectively). NO inhalation had no effect on forearm blood flow, yet increased the percentage of skin HbO2 by 2.3 +/- 0.3% (P < 0.001). Percentages of skin HbO2 were exponentially related to blood flow (R = 0.97, P < 0.001), indicating a limit to skin tissue oxygen saturation at high blood flows. Thus, for acetylcholine infusion leading to blood flows sevenfold greater than those of healthy resting African-American subjects, patients still exhibited lower percentages of skin HbO2 (65.2 +/- 0.2 vs. 77.5 +/- 0.2%, P < 0.001). Visible reflectance hyperspectral imaging demonstrates that either the stimulation or the administration of NO pharmacologically or by gas inhalation improves, but does not normalize, skin tissue oxygen saturation in patients with sickle cell disease.