Kakihana Yasuyuki, Kuniyoshi Tamotsu, Isowaki Sumikazu, Tobo Kazumi, Nagata Etsuro, Okayama Naoko, Kitahara Kouichirou, Moriyama Takahiro, Omae Takeshi, Kawakami Masayuki, Kanmura Yuichi, Tamura Mamoru
Division of Intensive Care Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
Adv Exp Med Biol. 2003;530:413-9. doi: 10.1007/978-1-4615-0075-9_38.
Currently, no on-line method of assessing cerebral oxygenation is sufficiently accurate to be clinically helpful. In an attempt to find a good predictor of postoperative cerebral outcome, we retrospectively studied the relationship between the redox behavior of cytochrome oxidase (cyt. ox.) during an operation and the neurological prognosis in 83 patients who underwent thoracic aortic surgery. Our data revealed three patterns of change in the redox behavior of cyt. ox. during the operation; the actual pattern exhibited by a given patient showed a highly significant correlation with the neurological prognosis (p < 0.0001). We conclude that the redox behavior of cyt. ox. during an operation is likely to be a good predictor of postoperative cerebral outcome, which implies that brain tissue oxygen sufficiency can be evaluated by near-infrared measurement of cytochrome oxidase (except for that in local regions far from the monitoring site).
目前，尚无一种在线评估脑氧合的方法足够准确到对临床有帮助。为了找到术后脑结局的良好预测指标，我们回顾性研究了83例接受胸主动脉手术患者术中细胞色素氧化酶（cyt. ox.）的氧化还原行为与神经学预后之间的关系。我们的数据揭示了术中cyt. ox.氧化还原行为的三种变化模式；特定患者表现出的实际模式与神经学预后高度相关（p < 0.0001）。我们得出结论，术中cyt. ox.的氧化还原行为很可能是术后脑结局的良好预测指标，这意味着可以通过细胞色素氧化酶的近红外测量来评估脑组织氧充足情况（局部远离监测部位的区域除外）。
