【作者】 陈蓉；

【导师】 王智彪；

【作者基本信息】 重庆医科大学 ， 妇产科， 2007， 硕士

【摘要】 近年来,高血脂人群快速增长,青年、中年人得高血脂症的人数大大增加。医学研究证明,高血脂与冠心病、高血压、脑中风、糖尿病的发生率有紧密的相关性,调脂治疗可以减少其发生率和死亡率,因为血脂增高是一个缓慢的过程,而血脂的调整及降低,消除血脂升高带来的不良影响也需一个持续作用的过程。长期口服药物治疗,对肝肾功能影响大,副作用多。如果用超声刺激穴位来调节血脂水平,也许是一种新的治疗措施。我们想通过本实验,首先研究超声的有效剂量,然后用成熟的高血脂动物模型,进行超声穴位辐照,观察动物的血脂变化,探讨超声刺激穴位治疗高血脂的可行性。第一部分聚焦超声辐照离体牛肝组织的生物学效应观察目的:探讨不同剂量的聚焦超声辐照牛肝组织的生物学效应,为聚焦超声辐照高血脂大鼠的穴位提供治疗剂量依据。方法:采用新鲜离体牛肝脏组织,常规脱气后,用聚焦超声治疗仪对牛肝脏组织进行定点辐射。治疗参数:脉冲波,脉冲频率1000Hz,超声波频率10MHz,辐照时间30s。用不同声功率辐照牛肝脏组织,观察辐照前后牛肝脏组织的病理改变及其温度变化。结果:当声功率为2W时,切开牛肝脏组织,可见辐照靶区组织呈灰白色凝固性坏死,大小为2×2×1mm3。当声功率为1.0W时,切开牛肝脏组织,肉眼见辐照靶区组织有可疑改变。将声功率逐渐递减至0.5W,测量靶区温度,1.5W、1.2W、1.0W、0.8W、0.5W分别上升6.3±0.52℃、5.8±0.41℃、5.5±0.55℃、4.6±0.52℃、2.5±0.55℃。结论:聚焦超声治疗仪的可控性好,当功率小于1.0W,脉冲频率1000Hz,超声波频率10MHz,时间30s内是安全剂量。在上述剂量下进行聚焦超声辐照,肉眼未见靶区组织出现凝固性坏死,靶区组织学结构未见明显改变。但有能量沉积于靶区,表现为靶区组织温度上升以及机械刺激等生物效应。第二部分大鼠高血脂模型的建立目的:建立SD大鼠高血脂模型,为聚焦超声治疗高血脂提供理想的实验动物模型。方法:将SD大鼠分为对照组和实验组,对照组喂养基础饲料,实验组喂养高脂饲料,2w后摘眼球取血检测,分别查血清TG、TC、HDL-C、LDL-C的变化。结果:实验组大鼠血清TG测定均值为3.52±0.36,TC为2.57±0.27,与对照组比较,差异有显著性(P<0.05),实验组大鼠的LDL-C明显升高,HDL-C明显降低,与对照组相比较均有显著性差异(P<0.05)。结论:本模型成功率高,方法简单易行,结果稳定,有利于长期观察和进一步的研究,是理想的大鼠高血脂模型。第三部分聚焦超声辐照涌泉穴对高血脂大鼠血脂水平的影响目的:用聚焦超声治疗仪辐照高血脂大鼠的涌泉穴位,检测血清TG、TC、HDL-C、LDL-C水平的变化,以探讨超声治疗高血脂患者的疗效。方法:将40只SD雌性大鼠,随机分成5组,空白对照组、实验对照组、超声治疗组1(1.0W)、超声治疗组2(0.5W)、针刺组。除空白对照组喂基础饲料外,其余继续喂养高脂饲料。超声治疗组在聚焦超声治疗仪额定的治疗参数下,分别以声功率1.0W、0.50W直接辐射大鼠的双涌泉穴位,针刺组用银针直刺大鼠的双涌泉穴位,均留针30s,隔日一次,连续治疗2w,停止治疗24h后采血检查。结果:血清TG、TC低。LDL-C水平超声治疗组1(1.0W)明显低于其他组(P<0.05),水平治疗组明显低于模型组(P<0.05)。以超声治疗组2(0.5W)下降最明显。HDL-C水平超声治疗组1(1.0W)高于其他组(P<0.05),针刺组最针刺组最高。肝脏组织切片治疗组较模型组肝细胞内脂滴有明显减少。结论:1.聚焦超声辐照高血脂大鼠的涌泉穴位,有明显调节血脂水平的作用。2.聚焦超声辐照大鼠涌泉穴位,通过经络作用,调节全身机能,能达到治疗目的。更多还原

【Abstract】 The recent years has seen a great increase of incidence of hyperlipemia, especially among the young and middle-aged population. Previous studies have proved the close relationship between hyperlipemia and the risk of coronary diseases, hypertension, apoplexy and diabetes, which can be reduced after lipid regulation. The development of hyperlipemia is a long and slow process, accordingly, the effort to reduce the lipid is also long and slow. However, long administration of medicine will exert damage on liver and renal functions and bring several side effects. Therefore, if ultrasound irradiation to Yongquan acupoint is effective in reducing lipid level, ultrasound therapy may offer a new alternative.This study tries to investigate the feasibility of focused ultrasound irradiation to Yongquan acupoint in the treatment of hypelipemia. We screened out the optimal ultrasound dose, which was then used to irradiate Yongquan acupoint of the hyperlipemia animal model. After irradiation, lipid changes were closely observed. Part I : Biological Effects of Focused Ultrasound on Ex Vivo Ox LiverObjective: To study the biological effects of focused Ultrasound on ex vivo ox liver so to provide the ideal dosage for ultrasound acupoint therapy. Method: Fresh ex vivo ox liver tissues were selected to be pointly radiated by focused ultrasound after general degassing. Treatment parameter: pulsed wave, pulsed frequency 1000 Hz, frequency of ultrasound waves 10 MHz, and duration 30 s. Different acoustic powers were applied, and then pathological and temperature changes of the target were observed.Results: Under acoustic power 2W, coagulation necrosis in ox liver was found. The size was 2×2×1 mm. Under acoustic power 1.0 W, suspectable changes could be found with naked eyes. When the power was gradually decreased to 1.5W, 1.2W, 1.0W, 0.8W, 0.5W, the target temperature raised by 6.3±0.52℃, 5.8±0.41℃,5.5±0.55℃,4.6±0.52℃and2.5±0.55℃, respe- ctively.Conclusion: Dosage with the following parameters (power<1.0 W, pulsed frequency 1000 Hz, ultrasound frequency 10 MHz and duration 30 s) was safe. This ultrasound dose does not induce coagulative necrosis, and histopathological observation did not find obvious changes of the irradiated tissues, nevertheless, it has energy deposition in the target which was expressed by temperature rise.Part II:Establishment of Hyperlipemia Rat ModelObjective: To establish hyperlipemia SD rat models as the ideal animal models for HIFU hyperlipemia treatment.Method: SD rats were assigned to control group and study group. Rats in control group were fed with normal feedstuff, while rats in study group were fed with high-fat feedstuff. Two weeks later, we obtained blood samples of the rat eyeballs and checked the changes of serum TG, TC, HDL-C and LDL-C .Results: Mean TG of the study group was 3.52±0.36, and mean TC was 2.57±0.27, which were significantly different from TG and TC mean values of the control group (P<0.05).In study group, HDL-C reduced obviously and LDL-C increased markedly, which had significant significance compared with the control group (P<0.05).Conclusion: The model is an ideal hyperlipemia model. It is characterized by high success rate, low cost and simple operation.Part III: Effect on blood fat level of hyperlipemia rats after irradiated by focused ultrasound to Yong Quan acupoint Objective: To investigate the therapeutic effect of focused ultrasound for treatment of hyperlipemia though detecting changes of TG, TC, HDL-C and LDL-C levels in blood serum after focused ultrasound radiation to Yong Quan acupointMethod: 40 female SD rats were divided randomly into 5 groups: blank group, control group, ultrasound group I (1.0W), ultrasound group II (0.5W) and acupuncture group. Blank group was given normal feedstuff, and other groups were all fed with high fat feedstuff. Utrasound group I and II were given Yong Quan acupoint ultrasound irradiation by 0.5 W and 1.5 W, respectively, while acupuncture group were given Yong Quan acupoint needle acupuncture for 30s every other day and for 2 weeks.Result: In aspect of TG and TC levels, the study groups had lower levels than the model group (P<0.05), and the ultrasound group II had the lowest levels. HDL-C level was highest in Ultrasound group I(P<0.05)and lowest in the acupuncture group. LDL-C level of ultrasound group I was obviously lower than that of the rest groups (P<0.05), and that of the acupuncture group was the highest. The lipid droplet of the hepatic cell in the study groups was much less than that in the model group.Conclusions: 1. Focused ultrasound irradiation to rat Yong Quan acupoint can effectively regulate blood fat level in hyperlipemia rats.2. Focused ultrasound irradiation to rat Yong Quan acupoint is able to enhance nerve and vascular functions, through which the functions of the whole body will be enhanced, so blood fat level can be normalized and treatment goal reached.更多还原