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研究生:杜宜紋
研究生(外文):Yi-wen Dou
論文名稱:靜脈注射滑石粉引起之肺臟組織病理學變化研究
論文名稱(外文):Pulmonary histopathology changes induced by intravenous-talc injection
指導教授:蕭開平蕭開平引用關係簡基憲簡基憲引用關係
指導教授(外文):K-pin ShawChi-Hsien Chien
學位類別:碩士
校院名稱:國立成功大學
系所名稱:細胞生物及解剖學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:英文
論文頁數:46
中文關鍵詞:滑石粉靜脈注射肺纖維化
外文關鍵詞:talcintravenous injectionpulmonary fibrosis
相關次數:
  • 被引用被引用:0
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  • 下載下載:37
  • 收藏至我的研究室書目清單書目收藏:0
摘要

毒販常利用滑石粉或澱粉等這些不同種類的藥物賦形劑來稀釋海洛因或是古柯鹼等毒品,因此在法醫解剖時常常可以發現,有長期靜脈注射毒品習慣的人,血管中會出現這些異物栓子、此外身上多重器官會出現由異物所引起的肉芽腫及慢性炎症反應,這種病理變化在肺臟特別明顯。由靜脈進入的異物,會傷害血管內皮細胞造成血管炎,導致肺臟出現慢性炎症反應及間質性纖維化。

本實驗的目的為觀察及分析、重複靜脈注射及單次靜脈注射滑石粉所造成的肺臟間質纖維化之差異。實驗組有3組,A組單次注射30mg滑石粉、B組單次注射3mg滑石粉、C組每周注射3mg滑石粉連續10周。滑石粉在光學顯微鏡下不易觀察,以偏光鏡觀察會呈現亮白色針狀結晶。以天狼星紅染色及偏光鏡來觀察慢性期第一型及第三型膠原纖維在肺泡壁間質沉積的情況,也利用Thomsen-Friedenreich抗體來觀察第二型肺泡細胞的密度變化。A組的肺泡巨噬細胞有顯著增生及活化、第三型膠原纖維沉積密度最高,第二型肺泡細胞密度最高。C組則是第一型膠原纖維沉積密度最高,第二型肺泡細胞密度最低。由實驗結果可得知,第三型膠原纖維沉積的密度是和初次刺激量呈正相關,此外、單次大量刺激在慢性期會造成較少量的肺間質纖維化,由肺泡巨噬細胞活化及第二型肺泡細胞密度增加顯示刺激有波及肺泡區以及有修復反應產生。而少量多次的靜脈滑石粉注射,會對血管內皮造成重複傷害,引起顯著的第一型膠原纖維堆積造成肺間質纖維化及大量的肺間質巨噬細胞增生,會對肺臟造成較大的傷害。
Abstract
Foreign body embolism and granuloma formation are the major histopathology findings of the pulmonary vascular complication in intravenous drug abusers. The lung of a drug abuser, shows not only chronic inflammation, granuloma and interstitial fibrosis but also crystal-like particle filled in the blood vessel and interstitial tissue. Purpose of this study is to identify the degree of interstitial fibrosis and the density of type two pneumocyte changes. In this study, rats are divided into three groups. Group A: 1 ml (30mg/ml) single intravenous injected (IV). Group B: 1 ml (3mg/ml) single IV. Group C: 1 ml (3mg/ml) weekly IV for 10 weeks. Sirius red stain is preceded under polarizing microscope to clarify the collagen production among those three groups. Proliferation of type two pneumocyte is one of the most sensitive pathological indicators of alveolitis after various lung injuries. By the use of Thomsen- Friedenreich (TF) antigen to identify type two pneumocyte and then calculate the density of type two pneumocyte (numbers/ mm septa length).Characteristics of group A include alveolitis, activation of alveolar macrophages, the highest type III collagen (Col III) density, and the highest type two pneumocyte density. Group B has mild pulmonary injury, focal pulmonary interstitial macrophage proliferation and activation. The characteristics of group C includes highest type I collagen (Col I) density, diffuse pulmonary interstitial macrophage proliferation and activation. The result shows the different degrees of intravenous talc injection induced pulmonary fibrosis. Multiple intravenous talc injections induce serious fibrosis than large dosage talc single intravenous injection does. The result helps to build a forensic data base of differentiate the cause of death of IV injection drug abusers.
Contents
`
A. Introduction……………………………………………1
B. Material and method………………………………….7
C. Result………………………………………………….12
D. Discussion…………………………………………….16
E. Reference……………………………………………..21
F. Table.………………………………………………….25
G. Figure………………………………………………….27
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