基于NADH荧光的组织病理生理状态多参数在体监测与评价
摘要
Real-time multiparametric evaluation of tissue pathophysiological conditions is of great value in animal experiments and for clinic applications, and is receiving more and more attention by researchers in life sciences and medicine. It is well known that the real-time monitoring of pathophysiological conditions in patients is required during surgical procedures and in intensive care units (ICUs). Whether a critical condition such as ischemia and hypoxia can be detected in vital organs, such as heart and brain, is directly related to patient survival. Early detection of microcirculatory disturbances in non-vital organs will also help to increase the success rate of surgeries such as organ transplantation, and decrease the incidence of post-operative complications. Conventional parameters, such as blood pressure, electrocardiogram and pulse, which are monitored in clinics, play important roles in the real-time evaluation of vital signs; however, they do not provide enough information to expose early changes in local tissue pathophysiological conditions at the molecular level. NADH is an intrinsic autofluorescent molecule involved in the redox reactions of the mitochondrial respiratory chain and serves as a sensitive marker, reflecting metabolic states and cell vitality. This paper introduces in vivo techniques to monitor the cellular metabolic states based on NADH autofluorescence. This method, combined with synchronous parallel monitoring of multiple parameters such as microcirculatory blood flow and hemoglobin oxygenation, will not only be useful in studies of pathophysiological mechanisms and evaluation of drug effects in vivo , but could also be clinically applied in surgeries and ICUs to provide real-time dynamic information of vital signs. At present, the technique of monitoring one-dimensional NADH fluorescent signals is well developed, and has been applied from in vitro experiments to living cells, animals, and in clinical studies. The two-dimensional imaging