应用激光多普勒血流仪监测口腔黏膜血流

Pilot study of laser-doppler flowmetry measurement of oral mucosa blood flow

目的：测量中国汉族人与高加索人的健康成年人口腔黏膜血流参数,比较口腔黏膜血流灌注情况在不同人种间的异同,比较口腔黏膜在上颌与下颌、男性与女性之间的差异性,为口腔种植临床中软组织处理提供参考依据。方法：从德国波恩大学在读学生中招募20名高加索人种学生（男性10例,女性10例,平均年龄25.3岁）和20名中国汉族留学生（男性10例,女性10例,平均年龄28岁）,口腔内设计8个测量点M1~M8,其中于上颌中切牙唇侧黏膜、下颌中切牙唇侧黏膜、上颌腭侧黏膜和颊黏膜各2个点。使用O2C激光多普勒血流仪进行血流参数测量,包括血氧饱和度（saturation oxygen,Sp O2）、平均血红蛋白量（relative amount of hemoglobin,r HB）、单位时间内血流量（flow）、血流速度（velocity）。结果：高加索人种和中国汉族两组之间比较,上颌中切牙血氧饱和度平均值分别为75.6%±8.2%和70.4%±7.6%;颊黏膜血红蛋白量平均值分别为79.9±5.8和83.5±6.6,差异有统计学意义,其余各位点血流参数差异无统计学意义。将测量位点各组之间进行比较：上腭黏膜的血氧饱和度为77.1%±10.9%,平均血红蛋白量为67.8±11.1,单位时间血流量194.1±63.7,相比较其他测量部位差异有统计学意义。男性多个测量位点血氧饱和度普遍低于女性,差异均有统计学意义。结论：口腔中不同解剖部位的黏膜血流灌注情况存在差别,性别之间血红蛋白氧结合能力可能存在差别,并且可能对于软组织愈合能力有一定影响;口腔黏膜血流灌注情况在小样本青年人群中的高加索人种与中国汉族人之间差异无统计学意义。

Objective： To explore and compare the perfusion pattern of oral mucosa on Han Chinese and Caucasian by laser-doppler flowmetry. Methods： A cross-sectional study was carried out, in 20 healthy Han Chinese adult subjects （average age： 28.4 years） and 20 healthy Caucasian （average age： 25.3 years） adult subjects, either gender with 10 subjects. Gingival perfusion was evaluated at 8 points （including upper incisor labial gingival, lower incisor labial gingival, palatal mucosa, cheek mucosa） using a laser-doppler flowmetry（O2C, Medizintechnik GmbH, Germany）. Each measurement was carried out 25 seconds consisting 5 seconds of foreperiod and 20 seconds of work period, without pressure. The measurements were taken by two well-trained doctors, each measurement was exammed 3 times by an examiner, and the average value was recorded as final data. Each measurement has 4 parameters ： SpO2 （ oxygen saturation） , rHB （ relative amount of hemoglobin） , flow （ the blood flow of unit interval） , and velocity （blood flow velocity）. We compared the data by different sites, different genders, and different races. Results： For palatal gingival, the average SpO2 was 77.1%± 10.9% , the average rHB 67.8 ± 11.1, and the average flow 194.1± 63.7, which presented significant lower values than other oral mucosa. There was no significant difference among other sites. There was some significant difference between the Caucasian and the Han Chinese： the maxillary central incisor oxygen saturation （SpO2） which were averages of 75.6% ± 8.2% and 70.4% ± 7.6% ; buccal mucosa hemoglobin （rHB） averages of 79.9 ± 5.8 and 83.5 ± 6.6, which had statistical differences. For most measurement points, the oxygen saturation on men was lower than that on women, which had significant difference. Conclusion： To investigate microcirculation pattern, oral mucosa can be the good observation site. Laser-doppler flowmetry is a well-documented instrument to survey on microcirculation. There may be differences between the genders in hemoglobin oxygen-binding capacity, which may have some impact on the ability of soft tissue healing. Oral mucosa display more blood perfusion than attached gingival. As the recipient site of gingival graft,maxilla and mandible have slight difference in blood supply.