Development of EPR and NIR Oximetry for Diabetic Foot

用于糖尿病足的 EPR 和 NIR 血氧测定法的开发

• 批准号: 7095603
• 负责人: NADEEM KHAN
• 金额: $ 23.99万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7095603
• 关键词: clinical research; diabetic angiopathy; diagnosis design /evaluation; electron spin resonance spectroscopy; foot; human subject; infrared spectrometry; noninvasive diagnosis; oximetry; oxygen transport; patient oriented research; skin ulcer; wound healing

DESCRIPTION (provided by applicant): Diabetes markedly raises the risk of microvascular and macrovascular diseases, major contributors to higher morbidity and mortality in this increasingly prevalent disorder. The resulting poor tissue oxygenation due to compromised circulation accounts for the poor healing, infection, and deterioration of foot ulcers in diabetics; this is the basic underlying pathophysiological factor. In current clinical practice, there is no technique available for direct determination of tissue oxygen content. Instead, clinicians need to rely on various methods that attempt to measure perfusion such as Doppler ultrasound, or an indirect measure of tissue oxygenation, transcutaneous oxygen measurement (TcO2). The latter detects oxygen diffusing through skin warmed to 42-44? C by the instrument, which has a complex relationship to the actual pO2 in the tissue. This project will apply 2 emerging techniques; electron paramagnetic resonance (EPR) oximetry and near infrared spectroscopy (NIR) to measure tissue oxygenation more directly and reliably in healthy volunteers. The ultimate aim is to extend the techniques to diabetic patients for clinical management of the disease. EPR is a new oximetry modality that directly measures tissue oxygen content and NIR oximetry characterizes the amount and saturation of intravascular hemoglobin, so a combination of these 2 techniques will provide complementary information about oxygen delivery and local concentration, providing a more complete picture of the tissue oxygenation. The major potential advantages of EPR and NIR are that they provide information not previously available, namely direct tissue oxygen content, and that meaningful repeated measurements can be obtained non-invasively over a long period of time. This information would be extremely useful for characterizing the status of the disease, and to determine the effects of therapeutic intervention on tissue oxygenation, and the relationship between oxygenation and progression of the disease. Promising preliminary results have been obtained, indicating the feasibility of following tissue oxygen in humans for years. If the promise of these techniques is fulfilled, clinicians will have a new powerful tool for management of peripheral vascular disease, based on fundamental pathophysiology.

描述（由申请人提供）：糖尿病显着增加微血管和大血管疾病的风险，这是导致这种日益流行的疾病发病率和死亡率较高的主要原因。由于循环受损而导致组织氧合不良，导致糖尿病患者的足部溃疡愈合不良、感染和恶化；这是基本的病理生理因素。在目前的临床实践中，没有可用于直接测定组织氧含量的技术。相反，临床医生需要依靠尝试测量灌注的各种方法，例如多普勒超声或组织氧合的间接测量、经皮氧测量 (TcO2)。后者检测通过加热至 42-44°C 的皮肤扩散的氧气？仪器测量的 C，与组织中的实际 pO2 具有复杂的关系。该项目将应用 2 项新兴技术；电子顺磁共振 (EPR) 血氧测定法和近红外光谱 (NIR) 可以更直接、更可靠地测量健康志愿者的组织氧合作用。最终目标是将这些技术推广到糖尿病患者，以进行疾病的临床管理。 EPR 是一种新的血氧测定方式，可直接测量组织氧含量，而 NIR 血氧测定可表征血管内血红蛋白的数量和饱和度，因此这两种技术的结合将提供有关氧输送和局部浓度的补充信息，从而提供更完整的组织氧合情况。 EPR 和 NIR 的主要潜在优点是它们提供了以前无法获得的信息，即直接组织氧含量，并且可以在很长一段时间内以非侵入方式获得有意义的重复测量。该信息对于表征疾病状态、确定治疗干预对组织氧合的影响以及氧合与疾病进展之间的关系非常有用。已经获得了有希望的初步结果，表明多年来跟踪人体组织氧的可行性。如果这些技术的承诺得以实现，临床医生将拥有一种基于基本病理生理学的新的强大工具来管理外周血管疾病。