Krupatkin A I
Fiziol Cheloveka. 2012 Jul-Aug;38(4):67-73.
Laser Doppler flowmetry, laser spectrophotometry of oxygen saturation and fluorescence determination of NAD-H/FAD ratio were carried out at 30 humans in the upper extremity skin zones with and without arteriole-venule anastomoses (AVA). For the first time it was shown that wavelet-analysis of oxygen saturation and microvascular blood flow oscillations was an effective approach to noninvasive estimation of skin oxygen extraction (OE) and oxygen consumption rate (OC). OE = (SaO2--SvO2)/SaO2, where SaO2 (%) and SvO2(%) are the oxygen saturation of arterial and venular blood, correspondingly. If the ratio between amplitudes of cardiac rhythm (Ac, p.u.) and respiratory rhythm (Ar, p.u.) Ac/Ar < or = 1, SvO2 = SO2. In the case of Ac/Ar >1, SvO2 = SO2/(Ac/Ar). OC = Mnutr x (SaO2-SvO2) in p.u. x %O2, where Mnutr--value of nutritive perfusion (p.u.). Mnutr = M/SI, where SI--shunting index of blood flow in microvessels. The values of perfusion, OE and OC were higher in the skin with AVA than in the skin without AVA. The values of perfusion and oxygen saturation were more variable in the skin with AVA. The greatest significance for tissue metabolism have the oxygen diffused from the smallest arterioles and capillaries. The contribution increased to tissue metabolism of total perfusion and of oxygen diffused from arterioles in the conditions of tissue ischemia.
对30名受试者上肢存在和不存在动静脉吻合（AVA）的皮肤区域进行了激光多普勒血流测量、氧饱和度激光分光光度测定以及NAD - H/FAD比率的荧光测定。首次表明，对氧饱和度和微血管血流振荡进行小波分析是无创估计皮肤氧摄取（OE）和氧消耗率（OC）的有效方法。OE = (SaO2 - SvO2)/SaO2，其中SaO2（%）和SvO2（%）分别为动脉血和静脉血的氧饱和度。如果心律幅度（Ac，单位：p.u.）与呼吸节律幅度（Ar，单位：p.u.）之比Ac/Ar≤1，则SvO2 = SO2。在Ac/Ar >1的情况下，SvO2 = SO2/(Ac/Ar)。OC = Mnutr×(SaO2 - SvO2)（单位：p.u.）×%O2，其中Mnutr为营养灌注值（单位：p.u.）。Mnutr = M/SI，其中SI为微血管血流的分流指数。有AVA的皮肤区域的灌注、OE和OC值高于无AVA的皮肤区域。有AVA的皮肤区域的灌注值和氧饱和度变化更大。从最小的小动脉和毛细血管扩散的氧对组织代谢具有最重要的意义。在组织缺血的情况下，总灌注以及从小动脉扩散的氧对组织代谢的贡献增加。
