邵耀華臺灣大學：應用力學研究所鄭鈞元Cheng, Chiun-YuanChiun-YuanCheng2007-11-292018-06-292007-11-292018-06-292006http://ntur.lib.ntu.edu.tw//handle/246246/62546微循環系統與整個血液的循環系統緊密關連，包含了微動脈、微血管、微靜脈等結構，是一個功能性的循環系統，人體中血液與組織細胞代謝物質的交換，主要就發生在微血管部分。許多疾病的徵狀也都容易在微循環中顯現。 本研究利用capillaroscope及顯微影像，來探討皮膚微循環生理學上與血液流動力學之間關係的研究，改變可能影響血流的參數，觀察其血液流變異常、微循環障礙，並且在量測藥物對於微循環的反應上，發現除了流速會隨著藥物的吸收而上升（0.38±0.29mms-1 to 0.37±0.22 mms-1）之外，影像也會隨之變得更加清晰；實驗數據的分析結果，流速也隨著溫度的上升約由0.35±0.27mms-1 t至0.67±0.20mms-1，與文獻探討中的數據大致相符合；也同時證實了低能量雷射對於微循環的功效（紅血球流速由0.37±0.24mms-1 上升至 0.45±0.30 mms-1）。本研究試圖提出合理的定量臨床參數，來作為將來醫師臨床上的應用。 本實驗的研究方法，使用價錢較為低廉的系統設備，能夠觀察平行於皮膚表面的單一條微血管在一個階段的時間變域內，幫助我們在實驗中得到不同於LDP流量儀的資訊，並且能夠成功的應用於活體的紅血球流速量測，提供臨床上實質的應用。Great finger nail matrix capillaries were continuously examined in 35 normal volunteers with the Lippolis capillaroscope . Under the increasing of body temperature red blood cell velocities(RBCV) were raised from 0.35±0.27mms-1 to 0.67±0.20mms-1 in 80.2% amounts of flowing cappilaries and 61.0% amounts of total capillaries. All subjects were treated with total triterpenic fraction of Centella asiatica (TTFCA) (0.1g on 1cm2 of nail finger), a drug active on microcirculation and capillary permeability. With the absorption of TTFCA, real-time images monitored on which the amounts of capillaries could be observed were raised were clearer and RBCVs were raised from 0.38±0.29mms-1 to 0.37±0.22 mms-1 in 24.7% amounts of flowing capillaries and 18.8% amounts of total capillaries. Under the Diode laser (low level laser irradiation) scanning, RBCVs were raised from 0.37±0.24mms-1 to 0.45±0.30 mms-1 in 95.1% amounts of flowing capillaries and 72.3% amounts of total capillaries. Both TTFCA and Diode laser were useful on nail fold by improving microcirculation. . The present method provided a less expensive system with which capillaries were measured relatively parallel to the skin for some period, the RBC particle traces and the corresponding velocity gave a better view of the vessel wall interaction, path irregularity, and upstream influence of pulsation. The present apparatus can be used for the capillaries on the nail fold of fingers, thus its clinical applications to any kind of microcirculation study is feasible.目 錄 誌謝…………………………………………………………………………Ⅰ中文摘要……………………………………………………………………Ⅱ英文摘要……………………………………………………………………Ⅲ目錄 ………………………………………………………………………Ⅳ圖目錄 …………………………………………………………………… Ⅴ 第一章 緒 論 …………………………………………………… 1 1-1 前 言 …………………………………………………… 1 1-2 研究動機與目的 ……………………………………………… 2 1-3 文獻回顧 ……………………………………………………… 9 第二章 實驗架構與設備……………………………………………… 14 2-1 實驗設備…………………………………………………… 14 2-2 實驗裝置與系統…………………………………………… 19 2-3 實驗對象…………………………………………………… 19 2-4 實驗步驟 ………………………………………………… 19 第三章 研究原理 …………………………………………………… 21 3-1 時間變域血球計算流速之原理…………………………… 21 3-1-1 工具軟體開發之步驟與原理………………………… 23 3-2 影像處理系統 ………………………………………………… 24 3-2-1 對齊影像中微血管輪廓……………………………… 24 3-2-2 影像二極化對比增強………………………………… 25 3-2-3 Thinning法求取中軸skeleton…………………… 25 3-2-4 計算M-line斜率………………………………………27 第四章 結果與討論……………………………………………………… 30 4-1 暫態溫度改變對微循環流速之影響…………………… 30 4-2 養分參數改變對微循環流速之影響…………………… 31 4-3 低能量雷射照射對微循環流速之影響………………… 32 4-4 人體生理時鐘對微循環流速之影響……………………33 4-5 不同參數（溫度、藥物）對微循環流速之影響…………34 4-5 討論………………………………………………………… 36 4-5-1 溫度與紅血球流速變化……………………………… 36 4-5-2 積雪草素藥物與紅血球流速變化…………………… 37 4-5-3 LLLI與紅血球流速變化……………………………… 37 4-5-4 溫度養分參數改變與紅血球流速變化之關係……… 38 第五章 結論…………………………………………………………… 42 參考文獻 ………………………………………………………………… 441918909 bytesapplication/pdfen-US微循環紅血球流速低能量雷射甲襞hemodynamicsnailfoldLLLIrbcvthesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/62546/1/ntu-95-R93543016-1.pdf