Development of EPR and NIR Oximetry for Diabetic Foot

用于糖尿病足的 EPR 和 NIR 血氧测定法的开发

• 批准号: 7095603
• 负责人: NADEEM KHAN
• 金额: $ 23.99万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7095603
• 关键词: clinical research; diabetic angiopathy; diagnosis design /evaluation; electron spin resonance spectroscopy; foot; human subject; infrared spectrometry; noninvasive diagnosis; oximetry; oxygen transport; patient oriented research; skin ulcer; wound healing

DESCRIPTION (provided by applicant): Diabetes markedly raises the risk of microvascular and macrovascular diseases, major contributors to higher morbidity and mortality in this increasingly prevalent disorder. The resulting poor tissue oxygenation due to compromised circulation accounts for the poor healing, infection, and deterioration of foot ulcers in diabetics; this is the basic underlying pathophysiological factor. In current clinical practice, there is no technique available for direct determination of tissue oxygen content. Instead, clinicians need to rely on various methods that attempt to measure perfusion such as Doppler ultrasound, or an indirect measure of tissue oxygenation, transcutaneous oxygen measurement (TcO2). The latter detects oxygen diffusing through skin warmed to 42-44? C by the instrument, which has a complex relationship to the actual pO2 in the tissue. This project will apply 2 emerging techniques; electron paramagnetic resonance (EPR) oximetry and near infrared spectroscopy (NIR) to measure tissue oxygenation more directly and reliably in healthy volunteers. The ultimate aim is to extend the techniques to diabetic patients for clinical management of the disease. EPR is a new oximetry modality that directly measures tissue oxygen content and NIR oximetry characterizes the amount and saturation of intravascular hemoglobin, so a combination of these 2 techniques will provide complementary information about oxygen delivery and local concentration, providing a more complete picture of the tissue oxygenation. The major potential advantages of EPR and NIR are that they provide information not previously available, namely direct tissue oxygen content, and that meaningful repeated measurements can be obtained non-invasively over a long period of time. This information would be extremely useful for characterizing the status of the disease, and to determine the effects of therapeutic intervention on tissue oxygenation, and the relationship between oxygenation and progression of the disease. Promising preliminary results have been obtained, indicating the feasibility of following tissue oxygen in humans for years. If the promise of these techniques is fulfilled, clinicians will have a new powerful tool for management of peripheral vascular disease, based on fundamental pathophysiology.

描述（由申请人提供）：糖尿病明显增加了微血管和大血管疾病的风险，这是这种日益普遍的疾病中高发病和死亡率的主要因素。由于循环受损而导致的组织氧合不良，原因是糖尿病患者足部溃疡的愈合，感染和恶化。这是基本的潜在病理生理因素。在当前的临床实践中，没有可直接确定组织氧含量的技术。取而代之的是，临床医生需要依靠试图测量灌注（例如多普勒超声）的各种方法，或者间接衡量组织氧合，经皮氧测量（TCO2）。后者检测到氧气通过皮肤扩散的氧气被加热到42-44吗？ c通过仪器，与组织中的实际PO2有复杂的关系。该项目将采用2种新兴技术；电子顺磁共振（EPR）血氧仪和近红外光谱法（NIR）在健康志愿者中更直接，可靠地测量组织氧合。最终的目的是将技术扩展到糖尿病患者以进行疾病的临床管理。 EPR是一种新的血氧仪方式，它直接测量组织氧含量和NIR血氧仪表征了血管内血红蛋白的量和饱和度，因此这两种技术的组合将提供有关氧气递送和局部浓度的互补信息，从而提供了更完整的组织氧合。 EPR和NIR的主要潜在优势是，它们提供了以前不可用的信息，即直接组织氧含量，并且可以在很长一段时间内非侵入性地获得有意义的重复测量。该信息对于表征疾病状况并确定治疗干预对组织氧合的影响以及疾病的氧合和进展之间的关系将非常有用。已经获得了有希望的初步结果，表明多年来人类跟随组织氧的可行性。如果实现这些技术的承诺，临床医生将基于基本的病理生理学，拥有一种新的强大工具来管理周围血管疾病。