Современные методы оценки кислородного статуса и состояния микроциркуляции биотканей: оптическая диффузионная спектроскопия (обзор)

Проблема изучения кислородного статуса и микроциркуляции биотканей представляет особый интерес для многих направлений медицинской науки, поскольку одной из причин развития гипоксии как типового патофизиологического процесса является микроциркуляторный «сбой», связанный с нарушением нормальной анатомии капиллярной стенки, изменением реологических свойств крови, ускорением или замедлением микрокровотока. Современные методы медицинской визуализации позволяют изучить процессы жизнедеятельности биосистем на самых разных уровнях организации: от органов и тканей до молекулярного состава веществ. Благодаря внедрению в клиническую практику методов функционального биоимиджинга появилась возможность наблюдать в режиме реального времени за процессами перемещения веществ в организме, мониторить параметры кровотока, оценивать уровень гипоксии, более детально характеризовать метаболизм и при этом вовремя проводить корректировку патологических состояний.

В обзоре представлены основные достоинства и недостатки таких методов имиджинговых исследований, как функциональная магнитно-резонансная томография в режиме BOLD, позитронно-эмиссионная томография, оптический имиджинг, лазерная доплеровская флоуметрия, транскутанная оксиметрия. Особое внимание уделено перспективной неинвазивной методике прижизненного изучения содержания веществ в биотканях — оптической диффузионной спектроскопии.

Принцип оптической диффузионной спектроскопии основан на способности тканевых хромофоров (оксигемоглобин, дезоксигемоглобин, жирные кислоты, коллаген) поглощать диффузно-рассеянный свет определенной длины волны. С учетом коэффициентов поглощения хромофоров рассчитывают их концентрации. Оптическая диффузионная спектроскопия внедряется в клиническую практику для диагностики степени малигнизации опухолей, оценки васкуляризации при реконструктивных операциях, диагностики гипоксических состояний тканей, интраоперационного мониторинга параметров кровотока, определения уровня гипоксии при сахарном диабете. С ее помощью представляется возможным определение и уточнение показаний к кожно-пластическим операциям и, возможно, к разработке новых способов кожной пластики.

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