微循環顯微觀測系統之設計製作與觀測指標模糊理論應用初步評估

Microcirculation Observing System Improvement and Preliminary Appraise on Fuzzy Clustering

陳國禔(Kuo-Ti Chen (Also know as : Tony K.T. Chen))

指導教授 ： 張炎林

中原大學/工學院/醫學工程研究所/碩士(2001年)

https://doi.org/10.6840/cycu200100105

摘要

微循環(Microcirculation)是生命的基本特徵之一，是循環系統的最末梢部分，既是循環的通路，又是物質交換的場所；既受全身性神經、體液的調節，又受局部需求的調節。微循環與其內皮細胞還扮演著訊息傳遞、分枝增生及損傷修補的角色。不同部位之微循環各項觀測指標，也能反應出臨床上不同程度的意義。
1985年起，大陸學者田牛等人分階段依次規範了甲襞微循環觀測及綜合定量評價，將甲襞觀測指標定出16項，將球結膜觀測指標定出21項。至1991年共完成甲襞、皮膚、眼球結膜、唇、舌、牙齦、耳廓、子宮頸、陰莖龜頭等9個部位之非侵入式微循環觀測及綜合定量評價。
人體接近表層皮膚均有微循環分佈，經由一般反射式顯微鏡、適當的光源及在觀測部位塗上適當折射率之透光液，便可透過皮膚非侵入式地觀測微循環顯微影像。現有之非侵入式微循環觀測系統便是依上述各項裝置加上其他週邊的組合，包括一部桌上型電腦及一台反射式立體顯微鏡，其設計在動物實驗或臨床觀測時限制頗多。
本研究的目的是應用工程原理與技術，進行改良設計與製作，包括硬體與軟體。在光源與顯微影像取像系統方面，改良設計與製作成專用結構，以數位攝影機記錄動、靜態影像，期使臨床觀測及動物實驗都能更方便，而有助於微循環研究者更容易取得資料。觀測所得之各項指標除了可使用原設備之專用軟體外，另外配合影像處理軟體做動、靜態影像處理，並提供以模糊推論決定管袢觀測指標的方法。由此推論可以顯示微細血管內的動態流速等更多的指標。
臨床觀測6位受測者在高壓氧治療前後之左手甲襞微循環影像，結果顯示在高壓氧治療後血液流速明顯下降；1位受測者觀測針刺內關穴時之左手甲襞微循環影像，可觀測到整體之顏色及血液流速均有改變；動物實驗以70公斤之閹豬為實驗對象，以每公斤體重注射50 mg之內毒素LPS，觀測到顏色及微細血管徑均有顯著變化。
由於在各種生理狀況之下會引起微循環的改變，有些指標在不同生理狀況下也會有相同的改變，有些指標只在某些生理狀況下才會發生改變。這種存在模糊性界限現象，適合採用模糊理論來處理。本研究嘗試利用模糊聚類分析、模式識別與綜合評價，以建立微循環模糊診斷系統之初步評估。

關鍵字

內毒素 ； 模糊聚類分析 ； 內關穴 ； 微循環 ； 高壓氧

並列摘要

Microcirculation, the fountainhead of life in nature, is the site of substances exchanges, which are regulated by nerve center and local fluid. Microcirculation and their endothelial cells also play roles in signal transduction, proliferation and circulatory repair. Capillary microscopy is widely used for examing the microcirculation in living subjects, both in health and disease.
Microcirculation can be observed noninvasively with sutible light source and by applying some thin transparent oil on the observation site. From 1985 to 1991, Tain Niu and some scholars have established the microcirculation observing parameters and comprehensive evaluation for nailfold (16 parameters), conjunctiva (21 parameters), skin, labium, linguae, gingiva, anthelix, cervix and glans penis.
In this study, based on engineering principal and technology to improve existing system both of hardware and software, an improved microscopic observing system was developed. The improvements of the system included modified light source, minimized microscopic device and digital video recording system.
Nailfold microcirculation was observed via the developed system in this study. The experimental findings showed that the blood flow velocity of nailfold microcirculation was significantly decreased after hyperbaric oxygenation therapy (n=6). In a normal subject, nailfold microcirculation was monitored before and after PC6 (Nei-Kuan point) acupuncture therapy. It was found that the image gray level and blood flow velocity were significant changed.
In addition, when endotoxin was injected intravenously into a 70 kgs castrate pig with dosage of 50 mg/kg, the subcutaneous layer microcirculation of inguinal region was found that the image gray level and microvessels diameter were periodicly changed with a wavy type.

並列關鍵字

Endotoxin ； PC6 (Nei-Kuan point) ； Hyperbaric oxygenation ； Microcirculation

參考文獻

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