続発性貧血における口腔粘膜血行動態の研究

抄録

The pallor of the skin and oral mucosa that is associated with anemia is thought to be due to a decrease in hemoglobin in the super ficial blood vessels. However, there has been little systematic research on this subject.
The authors of this paper used a tissue spectrum analyzer to measure the Lib (indicating hemoglobin concentration) and the Iso2 (indicating saturation). Experiments were conducted to determine the relationship between anemia and hemoglobin level in the oral mucosa, using the hemoglobin (Hb) value as the indicator.
The following conclusions were reached.
1. The areas of the oral mucosa which best correlate with the blood Hb level are the upper labial mucosa, lower labial mucosa, the back of the tongue, the sublingual surface, and the soft palate. The patients with secondary anemia showed reduced Lib levels (i. e. anemia) in all of these areas.
2. Measurements of IHb were graded to appear in the following order, from highest to lowest: labial mucosa, tongue, and then soft palate.
3. These measurements did not show a definite relationship between the IHb and the is in either patients with secondary anemia or in normal healthy people.
4. It was conjectured that patients on dialysis would tend to show a somewhat higher IHb on the back of the tongue than in other areas.
5. Sudden changes in blood volume, as in transfusions, surgery, etc., influence the oral mucosal hemodynamics. Reductions in the blood volume of thebody as a whole are accompanied by reductions in the blood volume of the oral mucosa. It was conjectured that the degree of this change in the oral mucosa would increase as the severity of anemia increased.
6. Among the five parts of the oral mucosa which were investigated, the back of the tongue showed the lowest correlation with the true state of anemia.
7. In order to determine the degree of anemia by hemodynamics of the oral mucosa, it is thought that the four parts (the upper and lower labial mucosas, the lower part of the tongue, and the soft palate) are the most reliable ones to observe.
From the above, it was concluded that, in secondary anemia (patients on dialysis, those having blood dyscrasis, a malignant tumor of the oral cavity, etc.), there is a distinct correlation between the tissue hemoglobin concentration (IHb) in the mucous membranes of the oral cavity and the true degree of anemia. This could be considered a useful method for clinical diagnosis.