口腔粘膜血流のレーザードップラーフローメトリー計測のパイロットスタディ

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

抄録

目的:

漢民族と白人の口腔粘膜の灌流パターンをLaser-Doppler Flowmetryで調べ、比較することである。

OBJECTIVE: To explore and compare the perfusion pattern of oral mucosa on Han Chinese and Caucasian by laser-doppler flowmetry.

方法:

健康な漢民族成人被験者20名（平均年齢28.4歳）と健康な白人成人被験者20名（平均年齢25.3歳）、男女各10名を対象に横断的研究を行った。歯肉灌流は，Laser-Doppler Flowmetry（O2C, Medizintechnik GmbH, Germany）を用いて8点（上切歯唇側歯肉，下切歯唇側歯肉，口蓋粘膜，頬粘膜を含む）で評価された．各測定は、5秒間のフォアタイムと20秒間のワークタイムからなる25秒間、無加圧で行われた。測定は訓練を受けた2人の医師によって行われ、各測定値は検査官によって3回検査され、その平均値が最終データとして記録された。各測定値には4つのパラメータがあります。SpO2（酸素飽和度），rHB（ヘモグロビンの相対量），flow（単位間隔の血流），velocity（血流速度）である。また、部位別、性別、人種別に比較した。

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 fore period 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 parame ters: 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.

結果:

口蓋歯肉では，平均 SpO2 が 77.1%±10.9%，平均 rHB が 67.8±11.1，平均 flow が 194.1±63.7 と他の口腔粘膜より有意に低い値であった．他の部位では有意な差は認められなかった．上顎中切歯の酸素飽和度（SpO2）は平均 75.6%±8.2%，70.4%±7.6%， 頬粘膜ヘモグロビン（rHB）は平均 79.9±5.8，83.5±6.6 であり，統計的に有意差がみられた．また，ほとんどの測定項目で，男性は女性より酸素飽和度が低く，有意差が認められた．

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.

結論:

口腔粘膜は，微小循環を観察するのに適した部位である．ヘモグロビンの酸素結合能には男女差があり，軟部組織の治癒能に影響を与える可能性がある．口腔粘膜は付着歯肉よりも血流が豊富である。歯肉移植のレシピエント部位である上顎と下顎では、血液供給量に若干の差がある。

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.