Takeuchi Satoru, Kawauchi Satoko, Sato Shunichi, Nawashiro Hiroshi, Nagatani Kimihiro, Kobayashi Hiroaki, Otani Naoki, Osada Hideo, Wada Kojiro, Shima Katsuji
Department of Neurosurgery, National Defense Medical College, Saitama, Japan.
Acta Neurochir Suppl. 2013;118:45-8. doi: 10.1007/978-3-7091-1434-6_7.
Intracerebral hemorrhage (ICH) is a common and often fatal subtype of stroke. Estimation of the stage of hemorrhage allows clinicians to know when the hemorrhage occurred, even in unconscious patients, enabling decisions to be made about the optimal management and treatment strategy. After ICH, oxidative denaturation of the hemoglobin progresses, and deoxyhemoglobin is gradually converted to methemoglobin. MRI has been used to estimate the stage of hemorrhage by evaluating the status of hemoglobin. However, there is currently no bedside device that can be used for the measurement of hemoglobin derivatives in patients with hematomas. The aim of the present study was to investigate the validity of using optical diffuse reflectance spectroscopy (ODRS) for bedside evaluation of the stage of hemorrhage. An ICH model was generated in adult Sprague-Dawley male rats by stereotactically injecting 50 μl of autologous blood into the right caudate nucleus. To analyze the hemoglobin derivatives in the hematomas, ODRS measurement was performed for the rats in vivo. In all rats, we found increased absorption at around 630 nm, which indicated the formation of methemoglobin. In conclusion, the results of the present study suggest that ODRS allows clinicians to more easily evaluate the stage of hemorrhage at the patient's bedside.
脑出血（ICH）是中风的一种常见且往往致命的亚型。对出血阶段进行评估可使临床医生了解出血发生的时间，即使对于昏迷患者也是如此，从而能够就最佳管理和治疗策略做出决策。脑出血后，血红蛋白的氧化变性会继续发展，脱氧血红蛋白会逐渐转化为高铁血红蛋白。磁共振成像（MRI）已被用于通过评估血红蛋白的状态来估计出血阶段。然而，目前尚无可用于测量血肿患者血红蛋白衍生物的床旁设备。本研究的目的是探讨使用光学漫反射光谱法（ODRS）对出血阶段进行床旁评估的有效性。通过立体定向向成年雄性Sprague-Dawley大鼠的右侧尾状核注射50微升自体血，建立脑出血模型。为了分析血肿中的血红蛋白衍生物，对大鼠进行了体内ODRS测量。在所有大鼠中，我们发现630纳米左右的吸收增加，这表明高铁血红蛋白的形成。总之，本研究结果表明，ODRS可使临床医生在患者床边更轻松地评估出血阶段。
