中國醫藥大學機構典藏 China Medical University Repository, Taiwan:Item 310903500/394
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    题名: 門脈高壓大鼠之脈波分析研究;Analyses of Pulse Waves in Portal Hypertensive Rats
    作者: 林承翰;Cherng-han Lin
    贡献者: 中國醫藥大學：中國醫學研究所碩士班
    关键词: 門靜脈高壓;脈診;諧波頻譜分析;心率變異性分析;血壓變異性分析;portal hypertension;pulse diagnosis;harmonic spectrum analysis;arterial pressure variability;heart rate variability
    日期: 2007-07-17
    上传时间: 2009-08-10 16:01:07 (UTC+8)
    摘要: 肝病是我國國民重大死因之一，每年死於肝病的國人超過5,000名。慢性肝病的種類繁多，肝硬化是其最後的轉歸，引發門靜脈高壓，衍生出許多併發症。臨床上患者多死於這些併發症。如何將門靜脈高壓控制得宜，成為臨床上的治療重點。門靜脈高壓產生高動能體循環狀態，對整體血液動力學產生影響。傳統中國醫學，是以脈診來評估血液動力學的變化。近代脈診研究，從頻域、時域、變異性等方式分析動脈壓力波，對脈波內的訊號逐漸了解。門靜脈高壓對血液循環的改變，理應能在動脈波中見到。故本實驗將分析門靜脈高壓大鼠之脈波，試圖探究門靜脈高壓對動脈波的影響。
    本實驗將12隻大鼠分為造型組與假手術組，實驗組將大鼠進行PPVL造型，30天後兩組皆進行股動脈與腸繫膜靜脈插管，並紀錄其動脈壓與門靜脈壓15分鐘。將所記錄脈波以傅立葉轉換成為諧波頻譜，以及以FFT轉換頻譜，進行血壓與心率變異性分析。結果顯示C0下降、C2、C3、C4、C5上升，顯示血液量在身體中間與下部增加。P4、P5、P6下降，顯示腸胃血液有蓄積現象。AP-LF下降、AP-HF升高，顯示交感活性增加。HR-VLF、HR-LF上升、HR-HF下降，顯示心臟受迷走神經刺激減少。
    由以上結果顯示，證實門靜脈高壓大鼠之脈波確有與正常大鼠不同之處，可佐證脈診的應用根據。若能更近一步將此變化定量，相信可為後續研究提供另一種監測指標。

    Chronic liver disease or cirrhosis has been one of most common causes of death in Taiwan. Cirrhosis is the end stage of any chronic liver disease. Portal hypertension is the main consequence of cirrhosis, and is responsible for most of its complications. Pulse diagnosis is a widely used technique in Chinese Medicine to assess patients. According to its related theories, hemodynamic changes can be obtained through finger sensations. Recent researches had more and more revealed its scientific foundations. In this study, we tried to investigate arterial wave changes in portal hypertension using PPVL rats.
    Twelve rats were separated into PPVL and Sham group. Rats form PPVL group were ligated by PPVL method. After 30 days, the 12 rats received femoral artery and ileocolic vein catheterization. The arterial and venous pressures were then recorded for 15 minutes long for analyses. The arterial pressure wave was transformed into frequency domain (Cn) by Fourier transformation, and then calculated the phases (Pn). Arterial pressure variability (APV) will be calculated by fast Fourier transformation (FFT) of arterial pressure wave. Heart rate variability (HRV) will be calculated by FFT of heart rate.
    Results showed a decrease in C0, but increase in C2, C3, and C4, while P4, P5, and P6 decreased. These indicated the accumulation of blood in middle and lower part of the body. AP-LF decreased and AP-HF increased indicated increased activity of sympathetic tone. Increases of HR-VLF, HR-LF, and the decrease of HR-HF suggested that vagal tone has less effect to the heart.
    Furthermore, this study suggested that the differences from arterial signals could be detected from arterial pressure wave in portal hypertensive rats. This could provide a feasible application of using pulse diagnosis to detect portal hypertension.
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