近红外光谱监测体外循环手术中脑组织氧合状况的研究

体外循环手术中,为防止因脑氧供需失衡导致脑缺氧,就要实时监测患者局部脑组织的氧合状况,以根据其变化调整生理参数或采取应急手段。用该研究小组自行研制的近红外仪器(使用一个双波长的近红外光源和两个近红外检测器)监测心脏手术中患者的脑氧,可以求出局部脑组织血红蛋白浓度的变化,并根据稳态空间分辨光谱(SRS)算法求出局部脑组织的氧饱和度(rSO₂)。体外循环中用监护仪监测患者的混合静脉血氧饱和度(SvO₂)等生理参数。测得的血红蛋白浓度变化容易受到干扰,而rSO₂的抗干扰性能较好。rSO₂在整个手术过程中都可以监测到,而SvO₂只能在体外循环过程中监测到。多数患者rSO₂和SvO₂存在正向相关性,但二者的相关系数并不很高。这是因为SvO₂是大静脉的血氧饱和度,而测得的rSO₂反映局部脑组织的氧合状况,二者的生理意义不同。实验结果表明,体外循环手术中rSO₂可以反映患者脑组织氧合状况的变化,而仅仅监测SvO₂是不够的。     

无损检测组织氧饱和度的近红外光学传感器的优化设计研究

基于空间分辨的近红外光谱(NIRS)技术可实现人体组织氧饱和度(rSO₂)的无损、实时检测。已研制出基于该原理的NIRS仪器,为推广其临床应用,必须保证并尽可能提高其测得rSO₂的准确度。文章主要研究传感器上多个检测器的间距以及光源发光波长离散性对rSO₂准确度的影响,结果指出：(1)为准确得到rSO₂,应当使用两个检测器,其间距应在5～20 mm,并且与光源的距离均应当不小于20 mm; (2)双波长光源的发光波长,特别是短波波长的离散性可导致测得的rSO₂出现明显误差(＞10%),为避免这一误差,必须准确测出实际的发光波长,并使用该波长对应的消光系数。上述结论可指导传感器的优化设计,所研制成的NIRS仪器实现了这一点。     

驾驶员疲劳态下脑氧饱和度的近红外光谱法检测及其分析

应用近红外光谱法,研究分析汽车驾驶员疲劳态下的脑氧饱和度,探讨疲劳机理,为驾驶疲劳及时预警提供新的监测思路。参试人员20名,分为两组(各10名),一组为实验组,一组为对照组。实验组执行汽车模拟驾驶作业3 h,对照组坐姿下正常休息3 h。应用近红外光谱法监测试验人员作业前后脑氧饱和度。经方差分析发现,实验组人员模拟驾驶后脑氧饱和度(rSO₂)显著性下降(p<0.01),反应时间明显延长;对照组rSO₂水平下降不显著(p>0.05)。脑氧饱和度水平(rSO₂)与驾驶疲劳存在密切相关性。近红外光谱法监测脑氧具有连续、实时、无创的特点,受外界干扰小。近红外光谱法监测驾驶员脑氧信息是预测驾驶疲劳的一种可行的方法。     

用近红外脑组织血氧仪评定保健食品抗疲劳效果

疲劳综合症目前已经越来越多地影响着人们的正常生活和工作。可以通过组织血氧饱和度、心率等参数来评价疲劳程度,并采用某种抗疲劳胶囊和咖啡作为调节疲劳程度的一种手段。基于空间分辨的近红外光谱(NIRS)技术可实现人体组织氧饱和度(rSO₂)的无损、实时检测。针对长时间在办公室工作的脑力劳动者人群,设计了两组静态实验来分别评价服用与未服用抗疲劳胶囊或咖啡的疲劳程度。通过对实验组和对照组受试者分别进行脑组织氧饱和度、心率等参数进行了测试,并侧重分析了受试者的脑组织氧饱和度的变化情况。结果表明,实验组的受试者其脑组织氧饱和度在服用抗疲劳胶囊和咖啡后都有明显的上升趋势,从而表明抗疲劳胶囊在一定程度上有缓解疲劳的作用。     

基于NIRS-ICG的脑血流量无创测量

临床上脑血流量(cerebral blood flow, CBF)等脑血管血流动力学参数是脑血氧水平及脑血管储备功能诊断依据,现有检测手段存在技术复杂及相应试剂或设备不适用于所有诊断人群等缺点。为解决以上问题,利用近红外光谱技术(NIRS)结合吲哚青绿(indocyanine green, ICG)脉搏色素浓度法,研究了一种无创、快速、可重复测量的脑血流量床旁检测方法NIRS-ICG。该方法根据静脉注射ICG后脑组织及脑动脉血流中三种主要吸光色团氧合血红蛋白(oxygenated hemoglobin, HbO₂)、还原血红蛋白(reduced hemoglobin, HbR)及ICG的浓度变化情况,建立脑组织及脑动脉血流中ICG积累量及引入量模型,以获得脑血氧及CBF等脑血流动力学参数。为验证该方法的可行性,将NIRS-ICG应用于血碳酸正常及高碳酸血症病理模型的实验猪的脑血流情况检测。具体方法是：分别对四组实验猪用按0%,3%,6%,9%比例调制的CO₂和空气混合气体施行机械通气,静脉快速推注ICG后,利用NIRS-ICG方法测量CBF、脑动脉血氧饱和度(cerebral arterial oxygen saturation, SaO₂)及脑血管管床平均循环时间(mean transit time, MTT)。实验结果表明,NIRS-ICG测得的CBF随CO₂比率升高而升高,SaO₂随着CO₂比例的升高而降低,MTT并无显著变化,与生理变化一致。因此,该方法可为脑血氧及脑血管储备功能诊断提供可靠依据。     

用光谱方法检测肌氧饱和度实现不同人群运动功能的评估

基于组织光学原理研发了组织氧饱和度无损检测仪。利用该仪器检测了101名受试者(其中健康锻炼者42人,健康不锻炼者34人,脾虚证患者25人)在进行递增负荷功率自行车运动实验时,股四头肌外侧头的肌氧变化过程。测得的血红蛋白浓度(c_tHb)受脂肪等外层组织影响较大,而肌氧饱和度(rSO₂)受影响较小。实验结果显示, 在运动过程中,随着运动负荷的逐渐增加,骨骼肌中的总血红蛋白浓度逐渐上升,肌氧饱和度逐渐降低;当运动停止后,总血红蛋白浓度和肌氧饱和度都出现快速上升。运动中肌氧饱和度的变化幅度与受试者运动能力有密切关系。利用局部组织氧饱和度这一指标来评价肌肉组织中氧的输送与消耗的平衡点,进而实现了对肌肉组织有氧代谢能力的定量评估。     

近红外光谱方法在颌面外科皮瓣移植术后监测中的应用

近红外光谱技术作为一种无创组织氧监测手段,近年来在整形外科手术术后监测方面得到了越来越多的重视。文章利用一套近红外无损组织氧检测系统对6例手术成功病例的移植皮瓣侧和对照侧正常组织内的氧饱和度进行了长时间对比监测,发现两侧的组织氧饱和度之间存在显著性差异。还对一例血管吻合失败的病例下颌部的多个位置进行了检测,发现坏死部位的氧饱和度和正常组织相比处于很低的水平。实验结果表明,近红外光谱检测技术对于皮瓣内的血氧浓度动态变化具有很好的灵敏度,在移植皮瓣的术后监测方面具有良好的应用前景。     

单波长光声光谱血氧饱和度检测技术研究

血氧饱和度(SO₂)为临床观察病情变化提供了有意义的指标。传统血氧饱和度检测研究工作多采用双光源和多光源光电容积脉搏波描记法实现无创检测来减少病人痛苦。通过研究生物组织对光的吸收和散射特性,将光谱学和光声技术相结合提出了一种无创式单光源检测血氧饱和度(SO₂)、脱氧血红蛋白浓度[HBR]和氧合血红蛋白浓度[HbO₂]的新方法。该方法基于血液对光信号的吸收和散射理论基础和光声信号呈现吸收线形关系建立单波长光声光谱血氧饱和度检测技术,不仅可以进行指标性参数分析还可以对组织成像。为了验证该技术可行性,在实验中采用单波长激光脉冲光源,以绿色和红色墨水的混合液体作为含有脱氧血红蛋白和氧合血红蛋白的血液模型注入软管模拟人体血液环境。其中红色墨水的含量类比于血液中含氧血红蛋白含量,从而可通过测量计算出红色和绿色墨水浓度来表征伪血氧饱和度(poseudo-SO₂)。实验结果表明,所测的伪血氧饱和度与实际浓度误差不超过6.97%,采用该方法量化血氧饱和度是可行的;同时利用实验结果,结合光声成像技术完成了对伪血液中单圆管截面成像。该方法替代多波长光谱分析的方法能显著降低激光系统和便携式实现成本。     

利用近红外光谱检测多层组织血氧饱和度的研究

利用近红外光谱无创检测生物组织血氧饱和状态,是一种极富研究和应用前景的检测技术,在临床检测中被广泛应用.但常规临床检测应用于指端仅反映局部血氧饱和度信息,在使用中具有局限性,信号的可信度也存在质疑.该文提出了一种采用反射式脉搏血氧饱和度检测技术检测生物多层组织氧合状况的新方法,该方法通过调节入射光强以适应解剖学中生物组织多层结构的检测.应用该方法针对手指结构的实验结果表明,随着入射光强的改变,反映血氧饱和状态的光电脉搏波信号有显著变化.结合手指解剖学分析表明,光电脉搏波信号的变化与手指的多层面组织结构相对应,反映不同层面血氧饱和状态.这一特点表明,通过此法可以针对生物组织的多层结构进行测量.     

血液成分无创检测中基于不确定度的光谱提取方法

近红外光谱血液成分无创检测技术发展至今已取得一系列进展。为进一步提高检测精度,基于动态光谱理论提出了一种改进的光谱提取方法：首先拟合出漂移基线,抑制了手指与夹具相对运动造成的影响;然后以方和根代替峰峰值组成光谱,减小了系统随机误差造成的影响。最后以血氧饱和度测量为例,对血氧饱和度系数Q进行不确定度分析,结合实验数据的理论分析表明以方和根代替峰峰值可使不确定度下降至原先的38%。在血氧饱和度检测实验中将改进后的方法与峰峰值法对比,可得精度更高的血氧饱和度系数Q,获得十组Q值的方差平均下降至原先的42%。理论分析与实验结果均表明,应用所提出的光谱提取方法可更加精确地从光电容积脉搏波中提取有效光谱,在血液成分的无创检测中有着重要的价值。     

Measurement of Cerebral Optical Pathlength as a Function of Oxygenation Using Near-infrared Time-resolved Spectroscopy in a Piglet Model of Hypoxia

Near-infrared spectroscopy (NIRS) has been used for measurement of changes in cerebral hemoglobin concentrations in neonates to study cerebral oxygenation and hemodynamics. In this study, measurements by time-resolved reflectance spectroscopy (TRS) were performed in a piglet model with various degrees of cerebral oxygenation to estimate the differential pathlength factor (DPF). A portable three-wavelength TRS system (TRS-10, Hamamatsu Photonics K.K.) with a probe attached to the head of a piglet was used. Eleven newborn piglets were anesthetized and respired by a ventilator to induce stepwise hypoxia loading. The DPF showed positive linear relationship with arterial hemoglobin (Hb) oxygen saturation and sagittal sinus venous Hb oxygen saturation at 761 and 795 nm. The DPF at 835 nm also showed very slight positive linear relationship with arterial hemoglobin oxygen saturation. The DPF values obtained in this study should contribute to a better understanding of noninvasive measurements by NIRS in neonates.     

A newborn piglet study of moderate hypoxic-ischemic brain injury by 1H-MRS and MRI

Cerebral hypoxia-ischemia (HI) is an important cause of perinatal brain damage in the term newborn. The areas most affected are the parasagittal regions of the cerebral cortex and, in severe situations, the basal ganglia. The aim of this study was to show that the newborn piglet model can be used to produce neuropathology resulting from moderate HI insult and to monitor damage for 7 days. Two acute cerebral HI were induced in newborn Large White piglets by reducing the inspired oxygen fraction to 4% and occluding the carotid arteries. Newborn piglets were resuscitated, extubated and monitored for 7 days. (31)P magnetic resonance spectroscopy (MRS) offers the ability to monitor the severity of the HI insults. Lactate (Lac) was detected in the HI group at 2 h, 3 days and 5 days after insult by (1)H MRS. Lac/n-acetylaspartate and Lac/choline and Lac/creatine ratios increased significantly (p < 0.01) in the HI group 2 h after HI insults and remained high over 7 days. For the HI group, mean T(2) values increased significantly in the parietal white matter (subcortical) for 5 days after HI insult [117.5 (+/-7.4) to 158.5 (+/-19.2) at T+3 days, 167.7 (+/-15.4) at T+5 days and 160.9 (+/-10.1) at T+7 days (p < 0.01)]. This newborn piglet model of moderate HI brain injury with reproducible cerebral damage could be use as reference for the study of neuroprotective strategy for a period of 7 days.     

Laser-induced photodissociation of oxyhemoglobin: Optical method of elimination of hypoxia (oxygen deficiency in biotissue)

We consider the effect of laser-induced in vivo photodissociation of blood oxyhemoglobin on gas exchange in biological tissues. An optical method of laser-induced oxygenation of biotissues is developed and proposed. We show that, in the region of the action of the laser radiation, the degree of oxygenation of a tissue increases. We experimentally confirm that the phenomenon of laser-induced in vivo photodissociation of oxyhemoglobin opens up a new possibility of controlling the local concentration of free molecular oxygen in tissues, eliminating tissue hypoxia, and stimulating aerobic metabolism of cells. We show that the efficiency of the proposed method of laser-induced oxygenation of biotissues proves to be comparable with the efficiency of the hyperbaric oxygenation, but has the advantage of the locality of the action. The proposed optical method of local oxygenation of biotissues will make it possible to eliminate the problem of hypoxia in cancerous tumor tissue and to considerably increase the efficiency of photodynamic, radiation, and chemotherapy in modern oncology.     

基于希尔伯特-黄变换的近红外脑功能成像信号分析

近红外光谱技术(Near-infrared spectroscopy,NIRS)已被广泛应用于无损大脑功能检测,然而传统时频分析方法并不适用于非稳态、非线性的血氧信号。在视觉刺激实验中,采集被试前额叶的血氧信号,分别比较了傅里叶谱分析法、小波谱分析法和希尔伯特黄变换(Hilbert-Huang transform,HHT)方法在近红外脑功能成像信号分析中应用的结果。实验表明基于希尔伯特黄变换的谱分析方法优于其它两种方法,并且使近红外光谱研究可以采用事件相关设计的实验,为形成近红外光谱信号分析的标准方法开辟了新的途径。     

Direct measurement of oxygen extraction with fMRI using 6% CO2 inhalation

The blood-oxygenation-level-dependent (BOLD) signal is an indirect hemodynamic signal that is sensitive to cerebral blood flow (CBF), cerebral blood volume (CBV) and cerebral metabolic rate of oxygen. Therefore, the BOLD signal amplitude and dynamics cannot be interpreted unambiguously without additional physiological measurements, and thus, there remains a need for a functional magnetic resonance imaging (fMRI) signal, which is more closely related to the underlying neuronal activity. In this study, we measured CBF with continuous arterial spin labeling, CBV with an exogenous contrast agent and BOLD combined with intracortical electrophysiological recording in the primary visual cortex of the anesthetized monkey. During inhalation of 6% CO2, it was observed that CBF and CBV are not further increased by a visual stimulus, although baseline CBF for 6% CO2 is below the maximal value of CBF. In contrast, the electrophysiological response to the stimulation was found to be preserved during hypercapnia. As a consequence, the simultaneously measured BOLD signal responds negatively to a visual stimulation for 6% CO2 inhalation in the same voxels responding positively during normocapnia. These observations suggest that the fMRI response to a sensory stimulus for 6% CO2 inhalation occurs in the absence of a hemodynamic response, and it therefore directly reflects oxygen extraction into the tissue.