在患有脑疟疾的儿童中,大脑微血管血红蛋白度增加
Rachel L Smith1, Allison K Ikeda1, Carol A Rowley1
1Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA.
Science translational medicine
|September 13, 2023
概括
大脑疟疾中的大脑胀可能是由血管拥堵引起的,而不仅仅是胀. 近红外光谱检测显示,受影响儿童的血红蛋白度较高,血流调节受损,与大脑胀相关.
科学领域:
- 神经科学是一个神经科学.
- 血液学 血液学 血液学
- 儿童传染病 儿童传染病
背景情况:
- 大脑疟疾是 * Plasmodium falciparum * 感染的严重并发症,通常导致致命的大脑胀.
- 在大脑疟疾中大脑胀的确切原因,无论是大脑胀还是血管拥堵,仍然不清楚.
- 不同的病理机制对组织血红蛋白度和脑血流产生不同的影响.
研究的目的:
- 研究大脑疟疾儿童中大脑微血管血红蛋白度的作用.
- 通过使用非侵入性技术,区分脑和血管拥堵作为导致大脑胀的原因.
- 评估儿童大脑疟疾中大脑血流调节的情况.
主要方法:
- 近红外光谱学 (NIRS) 用于在46名患有脑疟疾的马拉维儿童中非侵入性测量大脑微血管血红蛋白度.
- 对照组包括没有并发症的疟疾儿童 (n=33) 和健康儿童 (n=29).
- 阻断波动分析 (DFA) 描述了信号自我相似性,以评估大脑血流调节,MRI确定了大脑胀得分.
主要成果:
- 与没有并发症的疟疾 (82.9 μM) (P=0.008) 相比,患有脑性疟疾的儿童的脑微血管血红蛋白度 (145.2 μM) 显著更高 (P=0.008).
- 大脑微血管血红蛋白度与MRI (r=0.37,P=0.03) 确定的大脑胀得分正相关.
- 抑止波动分析显示,脑疟疾 (0.63) 与无并发性疟疾 (0.91) (P<0.0001) 的儿童中血红蛋白度信号的自我相似性较低,表明脑血流调节受损.
结论:
- 大脑疟疾中脑组织血红蛋白度升高表明,血液体积增加,可能是由于血管拥堵,导致大脑胀.
- 血红蛋白度信号的自我相似性受损表明大脑疟疾中大脑血流的失调.
- 非侵入性NIRS可以提供对儿科大脑疟疾中大脑胀病理生理学的见解.
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