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研究生:高潔靈
研究生(外文):Chieh-Ling Kao
論文名稱:頸上神經節摘除後大鼠心臟影像之變化
論文名稱(外文):Myocardial Imaging Following Superior Cervical Ganglionectomy in Adult Rats
指導教授:鄭澄意劉念先房同經房同經引用關係馬國興馬國興引用關係劉江川
指導教授(外文):Cheng C.Y.Liou N.S.Fang T.C.Ma K.H.Liu J.C.
學位類別:碩士
校院名稱:國防醫學院
系所名稱:生物及解剖學研究所
學門:生命科學學門
學類:生物訊息學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:65
中文關鍵詞:核子醫學造影頸上神經節交感神經
外文關鍵詞:123I-MIBG11C-HEDSuperior cervical ganglionectomy
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交感神經支配扮演著調控心臟功能重要的角色。因此,評估交感神經的活性,對於評估心臟功能以及交感神經的角色是一個相當重要的議題。然而交感神經究竟如何支配心臟活動,至今依舊尚未完全釐清。在過去文獻中,學者通常利用摘除星狀神經節以達到交感神經去支配的作用,用以觀察心臟功能的變化。為了瞭解交感神經活性對於心臟功能的調控角色,本研究將分別摘除左側及右側頸上神經節以作為交感神經去支配的動物模式。
本研究除了生理參數的紀錄、心臟切片的新腎上腺素轉運體染色觀察及心電圖記錄,更利用核子醫學123I-metaiodobenzylguanidine (123I-MIBG) 心臟平面造影以及 11C-hydroxyephedrine (11C-HED)心臟正子斷層造影來直接觀察體內的心臟影像,研究結果發現,在摘除右側頸上神經節的動物比摘除左側頸上神經節的動物和正常動物的核醫心臟影像目標區 (region of interest, ROI) 藥物沉積量有降低的現象,從定量化數據心臟與縱隔腔藥物濃度活性比率 (Heart-to-mediastinum, H/M ratio) 以及正子影像中的標準攝取量 (Standard uptake value, SUV) 來看,則可看出摘除右側頸上神經節的動物其H/M ratio和SUV皆明顯降低。在正常模式下生理參數比較,三組的心跳和血壓都無明顯差異;然而,當對動物施加熱休克模式時,摘除右側頸上神經節的動物,其血壓明顯較其他兩組低,且耐熱性明顯降低,動物會較早死亡。心電圖(electrocardiogram, ECG) 表現,可以看出摘除左側和右側頸上神經節的組別,其心電圖波形皆和正常大鼠不同;P波放大、QRS綜合波放大且T波甚至有反轉現象,說明了心臟去極化不同步造成去極化時間拉長。而在正腎上腺素轉運體免疫組織化學染色的研究中,摘除左側和右側頸上神經節組之新腎上腺素轉運體,染色結果因數目的改變而有外型上的變化。
本研究建立了一個成功的交感神經去支配作用的小型實驗動物模式,且在核子醫學影像方面有完整可供分析的影像。可初步推測交感神經去支配的急性期中,摘除右側頸上神經節對心臟調控較大,不僅核子醫學影像目標區藥物攝取量較低,在加熱模式下血壓方面更會有明顯變化。由此可得知,在交感神經去支配的急性期中,以核子醫學影像的直接觀察方式,可以更及時的發現其神經活動的異常。
Sympathetic nerve activity may address a crucial issue in the evaluation of the cardiac function. To assess the myocardial sympathetic activity, cardiac neuroimaging such as nuclear imaging, electrophysiology and norepinephrine transporter (NET) distributions, emerged as importantly direct measurements. Hence, we use these three ways (nuclear imaging, physiological recordings and NET immunohistochemistry) to investigate the cardiac function after the surgical ganglionectomy (Gx). Purpose: To establish an animal model of suppression of myocardial sympathetic innervation applying in heart studies, this current study will demonstrate the feasibilities of 123I-metaiodobenzylguanidine (123I-MIBG) and 11C-hydroxyephedrine (11C-HED) myocardial imaging, physiological recordings, and NET immunohistochemistry for monitoring myocardial sympathetic innervation following at superior cervical ganglionectomy. Methods: All SD rats are divided into 3 groups which are normal group, right-Gx (Rt-Gx) group, and left-Gx (Lt-Gx) group. After Gx, all rats were recorded of their electrocardiogram (ECG), heart rate (HR), blood pressure (BP), and scanned by conventional nuclear imaging and then the heart tissue were removed to process immunohistochemistry staining. Furthermore, the heat shock-induced responses were also recorded with the ECG, HR, and BP. Results: The imaging of the Lt-Gx group is similar to the normal group, but the imaging of the Rt-Gx group is different from the normal group,
(the region of interest (ROI) is lighter and smaller, the counts are lower). The average of heart-to-mediastinum activity ratio (H/M ratio) and myocardial washout of 123I-MIBG (MWO) of the Rt-Gx and the Lt-Gx groups are both lower than the normal group. For the physiological recordings, the HR and BP of the Rt-Gx and the Lt-Gx groups are similar to the normal group. The ECG of the three groups are different. The P waves and QRS complexs of Rt-Gx and Lt-Gx were emplified, and the T waves were reversed. Moreover, the records of heat shock-induced response were showed that the BP of the Rt Gx group were obviously lower than the other two groups, but the HR were not different from each other. In addition, the variations of NET morphology were detected at the Rt-Gx and the Lt-Gx groups. Conclusion: Non-invasive nuclear imaging can be a possible technique in earlier demonstration of sympathetic denervation in Gx rats than conventional physiological techniques. According to the physiological parameters, we suggest that the superior cervical ganglion may influence more in the blood pressure than in the heart rate. Furthermore, Gx rat may be a successful animal model of suppression of myocardial sympathetic innervation applying in heart studies.
目錄...............................Ⅰ
圖目錄.............................Ⅲ
表目錄.............................Ⅴ
中文摘要...........................Ⅵ
英文摘要...........................Ⅷ
壹、緒論............................1
一、交感神經與心臟功能之關係...........1
二、正腎上腺素與正腎上腺素轉運體........3
三、標記碘123間碘芐胍之心臟平面造影(123I-Metaiodobenzylguanidine cardiac planar imaging)......................4
四、標記碳11羥基麻黃素之心臟正子斷層造影(11C-Hydroxyephedrine cardiac PET imaging).............................7
貳、實驗目的..........................9
叄、材料與方法........................11
一、實驗架構..........................11
二、動物實驗..........................12
三、123I-MIBG心臟平面造影……..........13
四、11C-HED心臟正子斷層造影............14
五、生理參數紀錄.......................14
六、熱休克反應.........................15
七、免疫組織化學染色與組織切片...........15
肆、實驗結果...........................17
一、核子醫學影像造影....................17
1、123I-MIBG 心臟平面影像...............17
2、11C-HED 心臟正子斷層造影.............18
二、生理參數紀錄........................20
三、免疫組織化學染色觀察.................22
伍、結論...............................23
一、核子醫學影像造影與新腎上腺素轉運體.....23
二、生理參數的變化.......................27
陸、結論................................30
一、核子醫學造影.........................30
二、頸上神經節對心臟的支配作用.............30
三、核醫影像臨床之應用及小動物造影模式......31
柒、圖..................................32
捌、表..................................48
玖、參考資料.............................51
圖目錄
圖一:摘除頸上神經節後的大鼠之眼瞼下垂現象........................32
圖二:大鼠注射123I-MIBG後接受針孔呈相心臟平面造影之過程............33
圖三:大鼠接受股動脈插管之手術以及記錄生理參數之過程................34
圖四:大鼠單極肢電導配置位置.....................................35
圖五:正常大鼠的心電圖波形.......................................35
圖六:123I-MIBG之大鼠平面心臟影像................................36
圖七:11C-HED之大鼠正子斷層造影之全身影像.........................37
圖八:11C-HED之大鼠正子斷層造影之心臟影像.........................38
圖九:11C-HED之大鼠正子斷層造影與電腦斷層造影融合之心臟影像.........39
圖十:11C-HED之大鼠正子斷層心臟影像標準攝取量比較..................40
圖十一:大鼠生理參數的變化圖表...................................41
圖十二:各組大鼠心跳比較之柱狀圖.................................42
圖十三:各組大鼠血壓比較之柱狀圖.................................43
圖十四:各組大鼠心電圖之比較.....................................44
圖十五:熱休克模式下,各組大鼠血壓比較............................45
圖十六:熱休克模式下,各組大鼠心跳比較............................46
圖十七:大鼠心臟切片正腎上腺素轉運素之免疫組織化學染色觀察比較.......47
表目錄
表一:大鼠心臟與縱隔腔之藥物濃度比以及心肌沖刷藥物濃度比之數據比較....48
表二:11C-HED正子斷層影像之標準攝取量值比較.......................49
表三:實驗結果統整..............................................50
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