4种近红外脑氧仪模拟4500m高海拔环境的检测效果对比

Detection effects of 4 near-infrared cerebral oximeters:a comparative study in simulated high altitude(4500 m)

目的评价INVOS 5100C(美敦力)、EGOS-600(爱琴)和MNIR-P100(名希)、BRS-1(中科博锐)等4种近红外脑氧仪在高海拔环境中的检测效果。方法2021年3月3日~2021年3月16日招募到陆军军医大学男性健康志愿者174名,年龄18~22岁、身高(172.8±5.1)cm、BMI(22.5±2.2)kg/m^(2),用随机数字表法将受试者分为6组,每组29人,分别在平原(海拔300 m)和模拟4500 m海拔高度时采用4种近红外脑氧仪随机依次测量受试者的脑氧饱和度(regional cerebral oxygen saturation,rcSO_(2)),记录仪器的响应时间、受试者的血压(blood pressure,BP)、心率(heart rate,HR)、脉搏氧饱和度(pulse oxygen saturation,SPO_(2)),对比4种仪器检测响应时间、rcSO_(2)检测值之间的差异和一致性、rcSO_(2)与SpO_(2)之间的相关性。结果①4种脑氧仪在4500 m高原环境中检测成功率均为100%。INVOS 5100C、EGOS-600、MNIR-P100、BRS-1在平原响应时间分别为(2.13±0.34)s、(6.60±1.23)s、(2.87±0.48)s、(2.65±0.47)s,在高原响应时间分别为(2.22±0.41)、(6.83±1.25)、(2.86±0.49)、(2.67±0.49)s,其中EGOS-600的响应时间较其余3种仪器平均延长3 s以上(P<0.05)。MNIR-P100和BRS-1的响应时间与平原相比无显著差异(P>0.05),INVOS 5100C和EGOS-600的响应时间与平原相比分别平均增加了约0.1 s和0.2 s(P<0.05)。②在平原(300 m)BRS-1和INVOS 5100C的rcSO_(2)测量值一致性较EGOS-600和MNIR-P100更好,在模拟4500 m海拔高度,EGOS-600和INVOS 5100C的rcSO_(2)测量值一致性较BRS-1和MNIR-P100更好。受试者从平原至模拟高原环境时,BRS-1与INVOS 5100C测量rcSO_(2)下降幅度一致性比EGOS-600和MNIR-P100更好。③当INVOS 5100C达到以rcSO_(2)测量值下降超过基础值的20%为脑缺氧干预指标时,EGOS-600、MNIR-P100、BRS-1分别有78%、94%、76%的受试者未达到;当INVOS 5100C达到rcSO_(2)为50%绝对阈值作为脑缺氧干预指标时,EGOS-600、MNIR-P100、BRS-1分别有52.9%、54.6%、54.3%的受试者未达到。④INVOS 5100C、EGOS-600、MNIR-P100、BRS-1测量rcSO_(2)与SpO_(2)相关性系数分别为0.8764(P<0.0001)、0.6417(P<0.0001)、0.7618(P<0.0001)、0.6525(P<0.0001)。结论INVOS 5100C与3种国产仪器测量rcSO_(2)一致性较好,3种国产仪器反映rcSO_(2)降低的特异性较好,但敏感性稍差。

Objective To evaluate the detection effects of 4 brands of near-infrared cerebral oximeters(NICOs),INVOS 5100 C(Medtronic),EGOS-600(Aegean),MNIR-P100(Mingxi)and BRS-1(Casibrain Technology)in high-altitude environment.Methods From March 3,2021 to March 16,2021,a total of 174 healthy male volunteers(18~22 years old,172.8±5.1 cm,BMI 22.5±2.2 kg/m^(2))were subjected from Army Medical University,and then randomly divided into 6 groups(n=29).Their regional cerebral oxygen saturation(rcSO_(2)),instrument response time,blood pressure(BP),heart rate(HR),and pulse oxygen saturation(SPO_(2))were recorded and compared in the plain(300 m)and the 4500-m altitude environment.The correlations among the above indicators were evaluated by Pearson correlation analysis.The difference and consistency of above indicators by the 4 devices were investigated.Results①The effective detection rates of all 4 NICOs were 100%in 4500 m environment.In the plain environment,the response time was 2.13±0.34,6.60±1.23,2.87±0.48 and 2.65±0.47 s for INVOS 5100 C,EGOS-600,MNIR-P100 and BRS-1,respectively,while the time was 2.22±0.41,6.83±1.25,2.86±0.49 and 2.67±0.49 s respectively in the 4500-m altitude environment.EGOS-600 had the longest response time,with more than 3 s longer than the other 3 NICOs(P<0.05).There was no obvious difference in the response time in MNIR-P100 and BRS-1 between the plain and high altitude environment(P>0.05).But the response time of INVOS 5100 C and EGOS-600 was increased by 0.1 and 0.2 s respectively in the 4500 m altitude environment than the plain(P<0.05).②In the plain environment,INVOS 5100 C and BRS-1 showed better consistency in rcSO_(2) detection than EGOS-600 and MNIR-P100.While in the 4500 m altitude environment,EGOS-600 and INVOS 5100 C performed better consistency than BRS-1 and MNIR-P100.When the subjects entered from the plain to 4500 m altitude environment,the decline range showed better consistency in BRS-1 and INVOS 5100 C than EGOS-600 and MNIR-P100.③When taking the decline range of rcSO_(2) reaching 20%as the intervention value of cerebral hypoxia,78%,94%and 76%of the subjects respectively detected by EGOS-600,MNIR-P100 and BRS-1 were under the threshold.When taking the decline range of rcSO_(2) reaching 50%as the intervention value of cerebral hypoxia,52.9%,54.6%and 54.3%of the subjects respectively detected by EGOS-600,MNIR-P100 and BRS-1 were under the threshold.④The correlation coefficients of SpO_(2) and rcSO_(2) detected by INVOS 5100 C,EGOS-600,MNIR-P100 and BRS-1 were 0.8764(P<0.0001),0.6417(P<0.0001),0.7618(P<0.0001)and 0.6525(P<0.0001),respectively.Conclusion In terms of rcSO_(2),INVOS 5100 C shows great consistency with the 3 domestic NICOs,and the 3 domestic instruments also show great specificity but less good sensitivity.