Ogata H, Mishio M, Luo X X, Xu X
First Department of Anesthesiology, Dokkyo University School of Medicine, Tochigi, Japan.
Resuscitation. 1996 Nov;33(1):63-8. doi: 10.1016/s0300-9572(96)00984-7.
It is now possible to detect quantitative changes in cytochrome aa3 by means of near-infrared spectrophotometry. This technique is also suitable for determining oxidised hemoglobin (HbO2), reduced hemoglobin (Hb), cerebral blood volume, and the redox state of cytochrome aa3 (cyt aa3) in the tissues. The significance of elevated cyt aa3, measured by near-infrared spectrophotometry, is still unclear, so we investigated this question using both near-infrared spectrophotometry and oxygen saturation meters in endotoxemic dogs. Ten anaesthetised mongrel dogs were injected with endotoxin (E. coli 0111: B4 Difco 2 mg/kg i.v.) and the redox state of Hb and cyt aa3 was determined in real time by near-infrared spectrophotometry. The levels of arterial and cisternal venous oxygen saturation were recorded simultaneously by two Oximetrix 3 saturation meters to calculate the cerebral arterial and venous oxygen saturation difference (Sata-vO2D) in real time. HbO2 decreased along with the fall in mean arterial pressure and remained at a low level, while Hb increased and remained at a high level. The cerebral blood volume decreased in the endotoxic early stage and then returned gradually towards baseline. Cyt aa3 showed an increase following endotoxin injection and maintained an oxidised form. The cerebral Sata-vO2D rose to about three times the control level. From these observations, an increase of oxidised cytochrome aa3 after endotoxin administration seems to be a compensatory protective effect in response to the cerebral oxygen demand rather than over-oxygenation or hyperoxia.
现在可以通过近红外分光光度法检测细胞色素aa3的定量变化。该技术还适用于测定组织中的氧化血红蛋白(HbO2)、还原血红蛋白(Hb)、脑血容量以及细胞色素aa3(cyt aa3)的氧化还原状态。通过近红外分光光度法测得的细胞色素aa3升高的意义仍不清楚,因此我们在内毒素血症犬中使用近红外分光光度法和血氧饱和度仪对这一问题进行了研究。给十只麻醉的杂种犬注射内毒素(大肠杆菌0111:B4 Difco 2 mg/kg静脉注射),并用近红外分光光度法实时测定Hb和细胞色素aa3的氧化还原状态。用两台血氧饱和度仪3同时记录动脉和脑池静脉血氧饱和度水平,以实时计算脑动静脉血氧饱和度差(Sata-vO2D)。随着平均动脉压的下降,HbO2降低并维持在低水平,而Hb升高并维持在高水平。内毒素血症早期脑血容量降低,随后逐渐恢复至基线水平。注射内毒素后细胞色素aa3升高并维持氧化形式。脑Sata-vO2D升至对照水平的约三倍。从这些观察结果来看,内毒素给药后氧化型细胞色素aa3的增加似乎是对脑氧需求的一种代偿性保护作用,而非过度氧合或高氧状态。