鴿子低血壓模型中動脈壓與骨內壓之相關性

The Relationship between Arterial and Intraosseous Pressure in Pigeons (Columba rupestris) in Hypovolemic Model

王柏翔(Po-Hsiang Wang)

指導教授 ： 余品奐

國立臺灣大學/生物資源暨農學院/臨床動物醫學研究所/碩士(2022年)

https://doi.org/10.6342/NTU202204062

摘要

血壓在獸醫醫療中是重要的生理指標。但目前在鳥量測血壓的直接法或間接法，則分別因為侵入性等問題和不精確，使得無法廣泛實際應用於醫療中。先前在非洲灰鸚鵡的研究顯示，骨內空間中的壓力波型與流入骨頭的小動脈相關。為了進一步了解是否骨內壓力可作為量測血壓的替代方法，本實驗旨在找出鴿子(Columba rupestris)在低血量環境下骨內壓(IOP)與動脈壓(AP)之相關性，以及觀察是否骨內針位置會影響此關聯性。本實驗由國立臺灣大學實驗動物照護即使用委員會核准進行。本實驗將三十隻健康鴿子，依據骨內針放置位置隨機分為兩組。第一組為將骨內針放置於脛骨近端，而第二組則放置於尺骨遠端；二者皆使用22 gauge 1-1/4 英吋皮下注射針頭做為骨內針。同時，將24 gauge 3/4英吋留置針放置於深饒動脈(deep radial artery)。兩者分別用以測量骨內壓和動脈壓。兩壓力分別在0%、20%、30%和60%放血量的情形下同時測量10分鐘。擷取各階段最後五分鐘穩定之壓力波型和數值，並將其計算得出平均壓力。觀察動脈壓與骨內壓的關聯、是否骨內針上針部位會影響兩壓力關係，以及兩壓力在各階段的下降趨勢和關聯。結果顯示除了第一組在放血20%情形下，其餘平均壓力皆為常態分佈(p<0.05)。在失血0%、20%和30%情形下，尺骨之平均骨內壓可用以預測平均動脈壓(0.5<|r|, F>F0.05(1,13), P<0.05)。兩組之平均動脈壓和平均骨內壓在各放血間，倆倆都有顯著差異(p<0.05)。在線性模型下，尺骨之平均骨內壓在各階段的下降趨勢，比脛骨之平均骨內壓更接近平均動脈壓的下降情形。基於此結果，可知在鴿子低血量模型中，特別和正常狀態相比(0%放血)，平均動脈壓和骨內壓皆有顯著下降趨勢。另外，不論在兩者壓力的預測上和下降趨勢，尺骨骨內壓都比脛骨骨內壓，有更相近於平均動脈壓的相關性。本實驗之結果為低血量的鴿子，提供一個潛在的血壓量測替代方法。但在實際投入臨床應用前，仍需更多研究支持。

關鍵字

骨內壓 ； 動脈壓 ； 低血量模型

並列摘要

Blood pressure is an important vital sign in veterinary medicine. However, both direct and indirect blood pressure measurement methods are not practical due to the invasiveness and inaccuracy respectively. Studies in African grey parrots showed that the inflow arterioles likely account for the retained arterial waveform radiating into the intraosseous space. To further investigate if the routinely used intraosseous route could serve as a blood pressure assessing method, the aim of the research is to find out the relationship between intraosseous pressure (IOP) and arterial pressure (AP) in pigeons (Columba rupestris) using a hypovolemic model and whether needle placement sites affect the results; this research was approved by the IACUC of National Taiwan University. Thirty healthy pigeons were included in the study and divided into two groups randomly. The intraosseous route was set up in the distal ulna in one group and in proximal tibiotarsus in another using a 22-gauge 1-1/4 inch hypodermic needle. At the same time, a 24-gauge 3/4 inch catheter was placed into the deep radial artery. AP and IOP were recorded simultaneously under 4 stages for 10 minutes: 0%, 20%, 30% and 60% of blood loss. Pressure data were collected over 5-min interval in stable condition in all experimental stages. And the data were turn into value of mean pressure. The result showed mean intraosseous pressure (MOP) and mean arterial pressure (MAP) were normally distributed (p<0.05), except tibiotarsus MOP and MAP in 20% of blood loss. It was shown MOP of ulnar provide good prediction to MAP in 0%, 20% and 30% of blood loss (0.5<|r|, F>F0.05(1,13), P<0.05). Significant difference (p<0.05) was found in MAP and MOP of each stage of both groups. There was better correlation with decline trend between MAP and MOP of ulnar than MOP of tibiotarsus noted by linear model. According to the result, the decreasing tendency of both MAP and MOP is noted, especially compare to the normal stage (0% blood loss), in the hypovolemic model in pigeons. Besides, MOP of ulnar displayed better correlation to MAP in ability of prediction and similarity of decline trend than MOP of tibiotarsus. Results of this study provide a potential alternative option for blood pressure assessment in hypovolemic pigeons, but more studies have to be conducted before practical use.

並列關鍵字

intraosseous pressure ； arterial pressure ； hypovolemic model

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