臺灣博碩士論文加值系統

預防職業性曝露於人畜共通傳染病對與非人類靈長類接觸之工作人員至為重要。另方面，超音波掃描是評估心臟功能之首選診斷技術。為篩檢動物園和收容中心台灣獼猴 ( Macaca cyclopis ) 潛在性特定性病原，並進行心臟超音波掃描測定，在2005-2009年間對55隻圈養 ( 飼養於收容中心之獼猴 ) 和101隻野生 ( 生活於山上，但因侵入民宅而被捕獲關於收容中心之獼猴 ) 台灣獼猴，進行潛在性疾病檢查；其中20隻對上述潛在性病原檢查呈現陰性反應，且一般臨床 (包括體溫、呼吸數或心跳數檢查 )、血液學、血清生化學、血壓、心電圖、X光攝影和超音波掃描均正常之獼猴，被進行亮度 ( B )、運動 ( M ) 和都卜勒 ( D ) 模式心臟超音波掃描，以建立心臟超音波掃描測定之參考值。其結果如下：總共156隻獼猴之哺乳類舊型結核菌素試驗 ( mammalian old tuberculin human isolates; Colorado Serum Co.)和B型肝炎表面抗原檢驗 ( HBsAg assay; Surase B-96, General Biol. Co. 或Auszyme monoclonal, Abbott Lab. ) 均為陰性反應；但陽性率在A型肝炎IgG檢驗 ( Anti-HAV IgG assay; Abbott Axsym全自動免疫酵素分析儀 ) 有4.5% ( 7/156 )，在Herpes B virus IgG 檢驗 ( Herpes B Virus DIAdotTM ; VRL Lab. ) 有63.4% ( 92/145 )，在糞便寄生蟲檢查 ( 抹片和/或浮游法) 有9.6% ( 15/156 ，均為線蟲類)。在心臟超音波掃描測定值之建立上，20隻「臨床上健康」成年獼猴 (體重5.6-10.1公斤，10隻公猴與10隻母猴間體重並無顯著差異 )，以medetomidine 0.04-0.06 mg/kg混合ketamine 2.4-4.0 mg/kg行吹箭肌肉注射麻醉後，以二維B模式 ( two-dimensional B-mode ) 建立其右頭側胸骨旁掃描之心四腔室長軸斷層圖、左心室流出路斷層圖及心短軸斷層圖，以及左尾側胸骨旁掃描之心四腔室斷層圖和五腔室斷層圖等心臟超音波掃描術；然後以M模式 ( M-mode ) 及都卜勒模式 ( D-mode ) 測得種種心臟超音波掃描測定之參考值。最後以直線回歸分析各測定值與體重間之相關性，其結果顯示在M-mode心臟超音波掃描測定值中僅有心室中隔舒張末期厚度 ( interventricular septal thickness at end diastole，IVSd ) 和收縮末期厚度 ( at end systole，IVSs )、左心室後壁舒張末期 ( left ventricular posterior wall thickness at end diastole，LVPWd ) 和收縮末期厚度 ( at end systole，LVPWs )、左心室內徑短縮率 ( fraction shortening，FS ) 及左心房內徑 ( left atrial dimension，LAD )；而在D-mode心臟超音波掃描測定值中，僅有E波最高血流速率 ( velocity of E wave，VE )、E波壓力梯度 ( pressure gradient of E wave，PGE )、壓力-半時間 ( pressure half time，PHT )、僧帽瓣截面積 ( mitral valve area，MVA ) 及經僧帽瓣速率與時間積分值 ( velocity-time integral of transmitral fiow，VTImv )，與體重有顯著 ( P&;lt;0.05 ) 之正相關，但各項心臟超音波掃描測定值在性別間並無顯著之差異性。

It is very important to protect occupational exposure to zoonoses for persons working with nonhuman primates. On the other hand, echocardiography is the first choice of diagnostic techniques to evaluate the cardiac function. In order to detect out the latent specific pathogens and obtain the echocardiographic measurements for Formosan Macaques ( Macaca cyclopis ) in the zoo and rescue center, 55 captive (macaques reared in the rescue center ) and 101 free-living ( macaques lived in the mountain, but captured in the rescue center because invaded into resident’s house) Formosan Macaques were conducted the examinations of latent diseases during 2005-2009. And twenty of them with negative reaction to the various latent pathogens of above examinations, and with normal results on the general clinical (include the examinations of body temperature, respiratory rate and heart beat ), hematological, serum biochemical, blood pressure, electrocardiography, radiological and ultrasono- graphy examinations were performed brightness ( B-), motion ( M- ) and Doppler ( D- ) modes of echocardiography to establish the reference values of echocardiographic measurements. The results are as follows. A total of 156 monkeys were negative reaction on the mammalian old tuberculin test ( mammalian old tuberculin human isolates; Colorado Serum Co. ) and hepatitis B surface antigen assay ( HBsAg assay, Surase B-96, General Biol. Co. or Auszyme monoclonal, Abbott Lab.). But positive rates are 4.5% ( 7/156 ) on the hepatitis A IgG assay ( Abbott Axsym ), 63.4% (92/145) on the Herpes B virus IgG assay ( Herpes B Virus DIAdotTM ; VRL Lab.) and 9.6% ( 15/156 ) nematode infection on the fecal parasitic examination (smear and/ or flotation method ). On the establishment of echocardiographic measurements, twenty “clinically healthy” adult monkeys ( weight 5.6-10.1 kg, no significant difference between 10 male and 10 female macaques ) were intramuscularly anesthetized with combination of medetomidine 0.04-0.06 mg/kg and ketamine 2.4-4.0 mg/kg by blowgun injection. The long-axis 4 chamber, long-axis left ventricular outflow and right short-axis views on the right parasternal location, and the 4 chamber and 5 chamber views on the left caudal parasternal location were obtained under B mode two-dimensional echocardiographies. Then many varied reference values of echocardiographic measurements were measured with M- and D- modes of echocardiography. Finally the relationships between each measurement and body weight were analysed with the line regression, the result revealed that only the thickness of interventricular septum at end diastole ( IVSd ) and at end systole ( IVSs), left ventricular posterior wall thickness at end diastole ( LVPWd ) and at end systole ( LVPWs ), fraction shortening (FS ) and left atrial dimension ( LAD ) in the M-mode echocardiography, and only velocity of E wave ( VE ), pressure gradient of E wave ( PGE), pressure half time ( PHT ), mitral valve area ( MVA ) andvelocity-time integral of transmitral flow ( VTImv) in the D-mode echocardiography were significantly related to the body weight ( P&;lt;0.05 ), but no significant differencet between male and female monkeys was observed in each echocardiographic measurement.

目 錄
中文摘要……………………………………………………………………………Ⅰ
英文摘要…………………………………………………………………………III
謝誌......................................................Ⅵ
目錄......................................................Ⅶ
圖表目錄...................................................Ⅸ
第1章 前言…………………………………………………………………………1
第2章 文獻回顧 ……………………………………………………………………4
2.1台灣獼猴簡介……………………………………………………………………4
2.2台灣獼猴醫學用參考值…………………………………………………………5
2.3台灣獼猴疾病調查………………………………………………………………6
2.4心臟超音波掃描之應用…………………………………………………………8
2.5 心超音波掃描的回音顯示模式………………………………………………9
2.5.1 B模式心臟超音波掃描法………………………………………10
2.5.2 運動模式心臟超音波掃描法……………………………………12
2.5.3 都卜勒模式心臟超音波掃描法…………………………………15
2.5.4 頻譜都卜勒………………………………………………………15
2.5.4.1脈衝波頻譜式都卜勒………………………………………15
2.5.4.2連續波式都卜勒……………………………………………16
2.5.4.3高脈衝-反複頻率頻譜式都卜勒…………………………16
2.5.5 彩色都卜勒……………………………………………………16
2.5.6 能量都卜勒……………………………………………………17
2.5.7組織都卜勒超音波掃描…………………………………………18
2.5.8都卜勒超音波掃描心內血流速度的測定………………………18
2.6心臟超音波掃描術在野生動物之應用………………………………………19
2.7非人靈長類之心臟疾病………………………………………………………20
第3章 材料與方法 ………………………………………………………………21
3.1 試驗設計……………………………………………………………………21
3.2 寄生蟲檢查…………………………………………………………………21
3.3 皮內結核菌素試驗…………………………………………………………21
3.4 病毒性疾病檢查……………………………………………………………22
3.5 血液學檢查…………………………………………………………………22
3.6 血清生化學檢查……………………………………………………………23
3.7 心臟超音波掃描測定用獼猴之基本資料及一般臨床檢查............23
3.8 心臟超音波掃描測定用獼猴之血壓檢查…………………………………24
3.9 心臟超音波掃描測定用獼猴之心電圖檢查………………………………25
3.10 心臟超音波掃描測定用獼猴之X光攝影檢查....................25
3.11 心臟超音波掃描檢查………………………………………………………26
3.11.1 B模式心臟超音波掃描法…………………………………………27
3.11.1.1 右頭側胸骨旁掃描-長軸斷面…………………………27
3.11.1.2 右頭側胸骨旁掃描-短軸斷面…………………………28
3.11.1.3 左尾側胸骨旁掃描-四腔室斷面和五腔室斷面......28
3.11.2 M模式心臟超音波掃描測定………………………………………29
3.11.3 D模式心臟超音波掃描測定..........................30
3.12 統計學之分析………………………………………………………………30
第4章 結果…………………………………………………………………………32
4.1 皮內結核菌素試驗及寄生蟲檢查…………………………………………32
4.2 病毒性疾病檢查………...………………………………………………33
4.3 心臟超音波掃描用獼猴之基本資料及一般臨床檢查……………………35
4.4 心臟超音波掃描測定用獼猴之血液學檢查………………………………36
4.5 心臟超音波掃描測定用獼猴之血清生化學檢查…………………………37
4.6 心臟超音波掃描測定用獼猴之血壓檢查…………………………………38
4.7 心臟超音波掃描測定用獼猴之心電圖檢查………………………………38
4.8 心臟超音波掃描測定用獼猴之X光攝影檢查………………………………39
4.9 B模式心臟超音波掃描法之建立..............................39
4.9.1 右頭側胸骨旁掃描長軸斷面之建立………………………………39
4.9.2右頭側胸骨旁掃描短軸斷面之建立......................40
4.9.3左尾側 ( 心尖 ) 胸骨旁掃描長軸斷面之建立.............42
4.10 M模式心臟超音波掃描之測定...............................43
4.11 D模式心臟超音波掃描測定................................46
第5章 討論.......................................................50
參考文獻 …………………………………………………………………………55

圖表目錄
Fig. 1 The mammalian old tuberculin ( MOT ) used in this study………………………………………………………………………………22
Fig. 2 The example of a MOT positive reactor not found in this study………………………………………………………………………22
Fig. 3 The Sysmex K-1000 ( Japan ) used in this study for hematological examination………………………………………………23
Fig. 4 The Fujifilm RI-CHEM 3500 ( Japan ) used in this study for blood chemistry examination………………………………23
Fig. 5 PetMAP graphic blood pressure measurement device was used in a monkey in this study…………………………………………25
Fig. 6 Nihon kohden ECG 9020K was used in a monkey in this study………………………………………………………………………………25
Fig. 7 Shimadazu UD150L-F ( Japan ) used in this study for radiological examination…………………………………………………26
Fig. 8 The radiographic ventrodorsal view of a monkey used in this study…………………………………………………………………26
Fig. 9 FF sonic UF-750XT ( Fukuda Denshi ) medical sonographic instrument used in this study for echocardiographic examination…………………………………………27
Fig. 10 LOGIQ BOOK XP (GE Ultrasound Korea ) used in this study for echocardiographic examination.…………………………27
Fig. 11 The right parasternal location to obtain long-axis four chamber View.…………………………………………………………40
Fig. 12 The long-axis four chamber view obtained at the right parasternal location……………………………………………40
Fig. 13 The left ventricular outflow view to obtaine the right parasternal location.……………………………………………40
Fig. 14 The long-axis left ventricular outflow view obtained at the right parasternal location.……………………40
Fig. 15 The short-axis view of left ventricle obtained at the right parasternal location…………………………………………41
Fig. 16 The left caudal parasternal ( left apical ) location to obtain four chamber inflow view……………………42
Fig 17 The four chamber inflow view obtained at the left caudal parasternal location.……………………………………………42
Fig. 18 The left caudal parasternal ( left apical ) location to obtain the left ventricular outflow view………43
Fig. 19 The left ventricular outflow view obtained at the left caudal parasternal location. …………………………………43
Fig. 20 Diagrams of the locations of M-mode echocardiographic measurements…………………………………………43
Fig. 21 M-mode echocardiographic measurements through the left ventricular chamber level.………………………………………44
Fig. 22 M-mode echocardiographic measurements through the mitral valve level…………………………………………………………44
Fig. 23 M-mode echocardiographic measurements through the aortic valve level. ………………………………………………………44
Fig. 24 Pulse-wave Doppler echocardiographic measurements under the left ventricular inflow view of left apical parasternal location………………………………………………………47
Fig. 25 Pulse-wave Doppler echocardiographic measurements under the left ventricular ourflow ( 5 chamber ) view of left apical parasternal location.……………………………………47

Table 1 The sex and body weight ( kg ) of twenty Formosan macaques for study in the part Ⅱ……………………………………24
Table 2 Comparising the positive rates of mammalian old tuberculin test ( MOT ) and parasitic infections between captive and free-living macaques and among each year in both captive and free-living macaques used in this study…32
Table 3 Comparising the positive rates of hepatitis B surface antigen ( HBsAg ) and hepatitis A IgG ( Anti-HAV IgG ) between captive and free-living macaques and among each year in both captive and free-living macaques used in this study………………………………………………………………………………33
Table 4 Comparising the positive rates of Herpes B virus IgG between captive and free-living macaques and among each year in both captive and free-living macaques used in this study………………………………………………………………………………34
Table 5 Comparising the positive rates of Herpes B virus IgG in each year among the divisions of different ages in the macaques used in this study………………………………………35
Table 6 The means, standard deviations ( SD ) and ranges of body weight, body temperature, respiratory rate and heart beat in ten male and ten female Formosan macaques used for the echocardiographic measurements in this study……………36
Table 7 The hematological values of twenty Formosan macaques used for the echocardiographic measurements in this study………………………………………………………………………37
Table 8 The serum biochemical values of twenty Formosan macaques used for the echocardiographic measurements in this study.……………………………………………………………………37
Table 9 The systolic ( SBP ), diastolic ( DBP ) and mean arterial ( MAP ) blood pressures, and heart rate of twenty Formosan macaques used for the echocardiographic measurements in this study………………………………………………38
Table 10 The lead Ⅱelectrocardiograms of twenty Formosan macaques used for the echocardiographic measurements in this study.……………………………………………………………………38
Table 11 Echocardiographic values obtained from M-mode echocardio- graphic measurements in twenty clinically healthy Formosan macaques.………………………………………………45
Table 12 Regression equations of M-mode echicardiographic measurements vs. body weights with 95 % confidence interval of linear regression in clinically healthy macaques (X=body weight)……………………………………………………………………………46
Table 13 Echocardiographic values obtained from pulse-wave Doppler echocardiographic measurements in twenty clinically healthy Formosan macaques………………………………………………47
Table 14 Regression equations of pulse-wave Doppler echocardiographic measurements vs. body weights with 95 % confidence interval of linear regression in clinically healthy Formosan macaques. ( X= body weight )…………………49

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