Kim J G, Lee J, Roe J, Tromberg B J, Brenner M, Walters T J
Laser Microbeam and Medical Program, Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, USA.
Physiol Meas. 2009 Jul;30(7):529-40. doi: 10.1088/0967-3334/30/7/001. Epub 2009 May 13.
In this study, we hypothesized that non-invasive continuous wave near-infrared spectroscopy (CWNIRS) can determine the severity or reversibility of muscle damage due to ischemia/reperfusion (I/R), and the results will be highly correlated with those from physical examination and histological analysis. To test this hypothesis, we performed CWNIRS measurements on two groups of male Sprague-Dawley rats ( approximately 400 g) that underwent 2 h (n = 6) or 3 h (n = 7) of pneumatic tourniquet application (TKA). Tissue oxyhemoglobin [HbO(2)] and deoxyhemoglobin [Hb] concentration changes were monitored during the 2 h or 3 h of 250 mmHg TKA and for an additional 2 h post-TKA. Rats were euthanized 24 h post-TKA and examined for injury, edema and viability of muscles. Contralateral muscles served as controls for each animal. In both groups, [HbO(2)] dropped immediately, then gradually decreased further after TKA and then recovered once the tourniquet was released. However, releasing after 2 h of TKA caused [HbO(2)] to overshoot above the baseline during reperfusion while the 3 h group continued to have lower [HbO(2)] than baseline. We found a significant correlation between the elapsed time from tourniquet release to the first recovery peak of [HbO(2)] and the muscle weight ratio between tourniquet and contralateral limb muscles (R = 0.86). Hemodynamic patterns from non-invasive CWNIRS demonstrated significant differences between 2 h and 3 h I/R. The results demonstrate that CWNIRS may be useful as a non-invasive prognostic tool for conditions involving vascular compromise such as extremity compartment syndrome.
在本研究中,我们假设无创连续波近红外光谱技术(CWNIRS)能够确定缺血/再灌注(I/R)所致肌肉损伤的严重程度或可逆性,且结果将与体格检查和组织学分析的结果高度相关。为验证这一假设,我们对两组雄性Sprague-Dawley大鼠(约400克)进行了CWNIRS测量,这两组大鼠接受了2小时(n = 6)或3小时(n = 7)的气动止血带应用(TKA)。在250 mmHg TKA的2小时或3小时期间以及TKA后额外2小时内,监测组织氧合血红蛋白[HbO₂]和脱氧血红蛋白[Hb]浓度的变化。TKA后24小时对大鼠实施安乐死,并检查肌肉的损伤、水肿和活力情况。每只动物的对侧肌肉作为对照。在两组中,[HbO₂]立即下降,然后在TKA后进一步逐渐降低,而在止血带松开后恢复。然而,TKA 2小时后松开止血带导致再灌注期间[HbO₂]超过基线水平,而3小时组的[HbO₂]持续低于基线水平。我们发现从止血带松开到[HbO₂]首次恢复峰值的 elapsed 时间与止血带侧和对侧肢体肌肉的重量比之间存在显著相关性(R = 0.86)。无创CWNIRS的血流动力学模式在2小时和3小时I/R之间显示出显著差异。结果表明,CWNIRS可能作为一种无创预后工具,用于涉及血管受损的病症,如肢体骨筋膜室综合征。