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1.成都市第三人民医院心脏大血管外科,成都 610014
2.四川大学华西医院 麻醉科,成都 610041
3.四川大学物理学院,成都 610065
赵 龙,Email:godfather122000@126.com,研究方向:围术期氧供需平衡监测与调控。
魏 蔚,Email:weiw@scu.edu.cn 。
收稿:2024-09-30,
修回:2025-02-08,
纸质出版:2026-01-28
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赵龙,彭玲,张雪等.基于光电容积脉搏波的连续血红蛋白测量方法实验研究[J].重庆医科大学学报,2026,51(01):93-99.
Zhao Long,Peng Ling,Zhang Xue,et al.Continuous hemoglobin measurement based on photoplethysmography: an experimental study[J].Journal of Chongqing Medical University,2026,51(01):93-99.
赵龙,彭玲,张雪等.基于光电容积脉搏波的连续血红蛋白测量方法实验研究[J].重庆医科大学学报,2026,51(01):93-99. DOI: 10.13406/j.cnki.cyxb.003809.
Zhao Long,Peng Ling,Zhang Xue,et al.Continuous hemoglobin measurement based on photoplethysmography: an experimental study[J].Journal of Chongqing Medical University,2026,51(01):93-99. DOI: 10.13406/j.cnki.cyxb.003809.
目的
2
研究使用降主动脉光电容积脉搏波(photoplethysmography,PPG)测量血红蛋白(photoplethysmography hemoglobin,pHb)含量的可行性。
方法
2
选3~5月龄实验猪17只,体质量30~50 kg。麻醉后将反射式PPG探头置入食道并检测降主动脉PPG信号。通过血液稀释建立血红蛋白(hemoglobin,Hb)下降梯度变化,然后通过输血建立Hb上升梯度变化。每一梯度采集2 min PPG信号与血气分析的Hb参考值(Hb
ref
)对应建立关联数据集。在Matlab编写程序提取PPG信号中红光和红外光的交流分量和直流分量,并引入前馈神经网络模型获得pHb。使用直线相关分析、Bland-Altman和Polar Plot极坐标图分析pHb与Hb
ref
的一致性。使用误差网格图评估pHb测量误差的临床意义。
结果
2
在所有实验动物中均成功检测到降主动脉PPG信号。pHb与Hb
ref
的直线相关系数为0.81(
P<
0.01),测量偏倚较小(0.6 g/L)但一致性范围略大(-20.49~21.69 g/L);趋势变化一致率为59.3%;Clark误差网格图显示pHb和Hb
ref
测量误差在A/B/C区的分布分别为83%/16%/0%。
结论
2
基于降主动脉PPG构建连续pHb趋势测量是可行的,pHb与Hb
ref
具有中等相关性。连续pHb测量有作为趋势预测工具的潜力用于辅助临床决策。这项动物研究为未来开发床旁连续pHb监测奠定了实验基础。
Objective
2
To investigate the feasibility of descending aortic photoplethysmography(PPG) in the measurement of hemoglobin(pHb).
Methods
2
A total of 17 experimental pigs with an age of 3-5 months and a weight of 30-50 kg were selected. After anesthesia induction,a reflectance PPG probe was inserted into the esophagus to detect characteristic descending aortic PPG signal. The method of hemodilution was used to establish the gradient changes of the reduction in hemoglobin(Hb),and the method of transfusion was used to establish the gradient changes of the increase in Hb. Two-minute PPG signal was collected for each gradient to pair with the corresponding hemoglobin reference value(Hb
ref
) measured by blood gas analysis and establish a correlation dataset. A program was written in Matlab to extract alternating component and direct component for both red and infrared lights in PPG signal,which was introduced into a feedforward neural network model to obtain pHb. The linear regression analysis,Bland-Altman plot,and Polar Plot analysis were used to evaluate the consistency between pHb and Hb
ref
. The error grid analysis was also used to assess the clinical significance of pHb measurement error.
Results
2
The descending aortic PPG signal was successfully detected in all experimental pigs in this study. The linear correlation coefficient between pHb and Hb
ref
was 0.81(
P
<
0.01),with a relatively small bias(0.6 g/L) and a wide limit of agreement -20.49 to 21.69 g/L),and the consistency rate of trend ability was 59.3%. The Clark error grid analysis showed that 83% of the data were distributed within the Zone A,16% within the Zone B,and 0% within the Zone C.
Conclusion
2
It is feasible to establish a continuous pHb trend measurement based on descending aortic PPG signal,and there is a moderate correlation between pHb and Hb
ref
. Continuous pHb measurements may be used a potential trend prediction tool to facilitate clinical decision-making. This animal study
provides an experimental foundation for the development of bedside continuous pHb monitoring in the future.
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