臺灣博碩士論文加值系統

大腦因缺血性缺氧造成腦細胞立即及續發性損害，佔了大腦梗塞主要成因。在臨床上處理大腦缺血仍有很多不確定性，所以針對大腦缺血有不同的處理方式被提出，高壓氧處理就是其中之一。大腦缺血經高壓氧處理後會增加血漿含氧量，降低中性白血球吸附等作用﹔最近證據顯示經高壓氧處理能減少大腦梗塞面積和降低神經功能缺損。而缺血性腦中風造成腦組織神經元與神經膠細胞的交互作用，神經元受傷害會引起小神經膠細胞被活化，被活化的小神經膠細胞具清除細胞的功能，對於中樞神經系統缺血缺氧所造成傷害具有免疫反應能力。所以本實驗利用大腦中動脈血管阻塞模式，將術後的大白鼠分別不予高壓氧處理，及術後早期和晚期在三個絕對大氣壓高壓氧處理九十分鐘後觀察。在術後第二﹑四天犧牲，用免疫組織化學染色方法探討在腦皮質梗塞區腦巨噬細胞免疫分子的表現，比較在缺血性腦中風的老鼠經給予早期與晚期高壓氧處理對腦巨噬細胞免疫分子的表現。結果在術後第二﹑四天內，發現在受表現補體受器第三型OX42標記的腦巨噬細胞，早期接受高壓氧處理比未接受高壓氧處理的腦巨噬細胞，數目有明顯的降低﹔但在受表現主要組織相容抗原第二型分子OX6標記及受巨噬細胞上的溶菌體蛋白ED1標記的腦巨噬細胞，沒有數目上的明顯差異。可能原因在缺血性腦中風，早期高壓氧處理會抑制單核性白血球浸潤到腦梗塞區，降低腦巨噬細胞表現。這些結果或許能提供大白鼠在缺血性腦中風經早期高壓氧處理後神經膠細胞被活化的可能機轉之一。

Cerebral hypoxia is a major component of immediate and secondary cell damage caused by ischemia.The optimal clinical management of cerebral ischemic insult to the brain remains problematic.Various therapeutic regimens including hyperbaric oxygen have been proposed to protect the brain after an ischemic insult. Recent evidence showed the HBO treatment can reduce cerebral infarction area and decrease neurological deficits. Also recent evidence suggests that glial cells play an active role in the importance of active neuronal-glia interaction in the maintenance of homeostasis. These function become more significant in respose to a CNS insult such as ischemia. Observations on early reactions of microglia and macrophage after brain injury will be essential to clarify the contributions of these two cell types to the brain’s response to injury. A rat model of reversible occlusion of the middle cerebral artery (MCAO) was developed to assess the relationship of cellular elements and prophylactic hyperbaric oxygen on cerebral injury. Now we have investigated the reaction of brain macrophage after MCAO with/without HBO. The responses of brain macrophages were also exammined with antibodies, OX42, OX6 and ED1. Our results showed that HBO treatment reduced the population of brain macrophages bearing CR3 receptors (OX42) in the infarction area, but not those of brain macrophags with MHC class II antigen (OX6) or macrophage lysosomal protein (ED1). The marked attenuation of OX42 labeled brain macrophages indicated an effective suppression of monocytic invasion in the lesioned cortex. These results may provide the possible mechanism of early HBO therapy in the postischemic stroke of rats on glia reactions.

目錄…………………………………………………….……….I
圖目錄………………………………………………………...IV
中文摘要………………………………………………….…..VI
英文摘要…………………………………….…………...…VIII
第一章 緒論…………………………………………………...1
第一節 簡介...…………………………………………1
第二節 缺血性腦中風造成腦巨噬細胞被活化的機轉……………………………………………...2
第三節 缺血性腦中風動物實驗模式………………...6
第四節 高壓氧應用史. ……………………………….7
第五節 高壓氧與腦中風治療機轉及對免疫系統的影響……………………………………………...9
第六節 實驗目的………………………………….....11
第二章 材料與方法………………………………………….12
第一節 動物實驗大腦中動脈阻塞手術方法……….12
第二節 標本製作……………….……………………12
第三節 免疫組織化學染色…………………….……13
第三章 實驗結果………………..…………………………...15
第一節 正常中樞神經系統中的小神經膠細胞免疫組織化學染色……………………………..…...15
第二節 缺血性腦中風與腦巨噬細胞之免疫組織化學染色………………………………………….16
第四章 討論………………………………………………….21
第五章 結論………………………………………………….25
第六章 參考文獻…………………………………………….26

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