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Non-Invasive Study of Tissue Oxygen Metabolism Using Near Infrared laser Light ; Toward its Clinical Application

使用近红外激光对组织氧代谢进行非侵入性研究；

基本信息

批准号：
01480337
负责人：
TAMURA Masahide MD
金额：
$ 4.48万
依托单位：
Asahikawa Medical College, Faculty of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

项目摘要

A new protable high performance apparatus for near infrared (NIR) laser spectrophotometry was developed to monitor the oxygenation state in human brain. Three different wavelengths of 780, 805 and 830nm of the NIR laser beam were used and each laser light illuminated alternatively the head through a fiber optic bundle. The amount of light reflected by or transmitted from the tissue was detected by the photomultiplier or silicone photodiode. The output signals of the photodiode were processed by a microcomputer, and the time course of calculated oxy, deoxy and total (oxy^+deoxy) hemoglobin (Hb) values were recorded in real time using the equations developed in our lavoratory. The calculation equations were verified in vivo with the rat head to confirm the reliability and acceptability of our methodology. NIR monitring was applied to 20 cases of cardiopulmonaly bypass patients in reflectance mode. The results demonstrated that in current CPB technique, the cerebral oxygenation levels during the bypass were maintained within the physiological range and the changes en the brain blood volume corresponded well to the pump flow balance. That is, the brain oxygenaation level was maintained roughly constant at a mean perfusion pressure of over 60mmHg during CPB, whereas below 50mmHg, a progressive decline in the Hb oxygenation was observed. These findings led us to conclude that non-invasive monitoring of cerebral oxygenation using NIR light can provide valuable data at the bed side about tissue metabolism and allow for the proper management of critical patients.The problems that remain to be solved with this system include : 1) the absolute quantification of the changes in cerebral oxygenation and blood volume, 2) clinical introduction of a cytochrome oxidase redox measuring system to obtain information concerning ; the brain cell functions directory and 3) a further clinical evaluation of NIR informations obtained so far.

研制了一种新型便携式高性能近红外激光分光光度计，用于监测人脑氧合状态。使用三种不同波长的780、805和830nm的NIR激光束，并且每种激光通过光纤束交替地照射头部。通过光电倍增管或硅光电二极管检测组织反射或透射的光量。光电二极管的输出信号由微型计算机处理，并使用我们实验室开发的方程真实的记录计算的氧合、脱氧和总（氧合^+脱氧）血红蛋白（Hb）值的时间过程。用大鼠头在体实验验证了计算公式的可靠性和可接受性。本文对20例体外循环病人进行了近红外反射式监测。结果表明，在目前的CPB技术中，转流期间的脑氧合水平维持在生理范围内，脑血容量的变化与泵流量平衡良好地对应。也就是说，在CPB期间，脑氧合水平在平均灌注压超过60mmHg时保持大致恒定，而低于50mmHg时，观察到Hb氧合进行性下降。这些发现使我们得出结论，使用近红外光的脑氧合无创监测可以在床边提供关于组织代谢的有价值的数据，并允许对危重患者进行适当的管理。该系统仍有待解决的问题包括：1）脑氧合和血容量变化的绝对定量，2）细胞色素氧化酶氧化还原测量系统的临床引入，以获得关于脑细胞功能目录的信息，以及3）迄今为止获得的NIR信息的进一步临床评价。