本文選題：前庭半規(guī)管 + 橢圓囊內(nèi)淋巴閥��； 參考：《大連理工大學(xué)》2013年博士論文

【摘要】：人內(nèi)耳前庭系統(tǒng)在維持身體平衡中起著先導(dǎo)作用。但是由于內(nèi)耳埋藏位置深,結(jié)構(gòu)復(fù)雜而精細,導(dǎo)致前庭常見疾病的病因和發(fā)病機制尚需明確,前庭功能檢查定側(cè)和定位上的診斷還缺乏有效手段,前庭疾病的治療多限于對癥。前庭系統(tǒng)功能異常和病理變化以及過度的外界環(huán)境激勵是誘發(fā)眩暈的重要原因,嚴重影響了人們的生活質(zhì)量。對于飛行員等特殊職業(yè)人員眩暈是導(dǎo)致飛行事故的重要因素。生物力學(xué)因素在內(nèi)耳前庭系統(tǒng)行使平衡功能的過程中起著重要作用,其中前庭半規(guī)管感受頭位有角運動依賴于管中內(nèi)淋巴液的流動和嵴頂形變之問的相互作用和一個機電傳導(dǎo)過程。將力學(xué)的基本原理與方法應(yīng)用于人內(nèi)耳前庭系統(tǒng)結(jié)構(gòu)與平衡機制的相關(guān)性研究,可為探討眩暈病癥與內(nèi)耳結(jié)構(gòu)的相關(guān)性,提高前庭功能檢查定側(cè)、定位診斷敏感性,尋找有效治療方法等提供定量依據(jù)。本文主要工作包括： 1、通過對豚鼠內(nèi)耳結(jié)構(gòu)的研究,獲得豚鼠內(nèi)耳結(jié)構(gòu)三維重建的有效方法。在此基礎(chǔ)上,根據(jù)一例正常人內(nèi)耳前庭半規(guī)管結(jié)構(gòu)的數(shù)據(jù),對其幾何結(jié)構(gòu)進行三維重建。采用有限元法對該半規(guī)管內(nèi)淋巴液——嵴頂耦合系統(tǒng)進行了模態(tài)分析,得到系統(tǒng)的基頻為13.46Hz,遠高于人日常自然活動頻率以及臨床旋轉(zhuǎn)試驗和冷熱試驗的檢查頻率。 2、進行了體位變化激勵下人雙耳前庭半規(guī)管平衡機制的數(shù)值分析。結(jié)果表明,頭繞對稱軸水平正弦轉(zhuǎn)動或左右正弦滾轉(zhuǎn)時,左右耳對稱半規(guī)管的力學(xué)響應(yīng)幅值相等,相位相差3.14rad,使得對稱半規(guī)管的刺激強弱相反：頭前后正弦翻轉(zhuǎn)時,雙耳對稱半規(guī)管的力學(xué)響應(yīng)幅值和相位均相等,使得對稱半規(guī)管的刺激強弱相同。由此推斷任意頭位變化,通過前庭眼反射,雙耳前庭半規(guī)管中的力學(xué)響應(yīng)將誘發(fā)雙眼向相同的方向等幅度轉(zhuǎn)動,維持視網(wǎng)膜成像的穩(wěn)定。 3、對健康人雙耳前庭半規(guī)管在人自然活動頻率范圍頭水平轉(zhuǎn)動進行了頻率特性分析,尋找前庭半規(guī)管振動的特異性。研究發(fā)現(xiàn)水平半規(guī)管嵴頂橢圓囊側(cè)表面的振動幅值對轉(zhuǎn)動加速度較敏感,而管側(cè)表面對轉(zhuǎn)動速度較敏感,嵴頂振動的相位只與外載荷頻率相關(guān)。隨著外界載荷頻率增大,水平半規(guī)管嵴頂兩側(cè)的振動幅值和相位差均增大。根據(jù)這一特異性,可以通過臨床旋轉(zhuǎn)試驗定位評估水平半規(guī)管功能。 4、進行了環(huán)境溫度激勵下人雙耳前庭半規(guī)管平衡機制的數(shù)值分析。結(jié)果表明在外耳道口持續(xù)灌注冷熱水或氣,水平半規(guī)管被激勵約20s后,前半規(guī)管才被穩(wěn)定激勵；約40s后,后半規(guī)管被穩(wěn)定激勵。推測臨床Hallpike冷熱試法對前后半規(guī)管功能的評估不可靠。為了通過冷熱試法可靠地評定前后半規(guī)管的功能,需要延長在外耳道口灌注冷熱水或氣的時間,這個規(guī)律適用于任何頭位冷熱試驗評定前庭半規(guī)管功能。 5、探討了橢圓囊內(nèi)淋巴閥在人內(nèi)耳前庭半規(guī)管平衡機制中的作用,對尚未明確的橢圓囊內(nèi)淋巴閥的功能進行了探索。橢圓囊內(nèi)淋巴閥張開后,任意頭位變化,會使得內(nèi)耳膜迷路上部和下部的內(nèi)淋巴液體積不等量交換。如果體位變化激勵越大,橢圓囊內(nèi)淋巴閥的開口面積越大,通過開口交換的內(nèi)淋巴液的體積將越多,對嵴頂變形運動的影響會越大,從而影響半規(guī)管的平衡機制。本文研究結(jié)果表明,橢圓囊內(nèi)淋巴閥在前庭半規(guī)管行使平衡功能的過程中起著重要作用,如果其功能異常,可能增加梅尼埃病和良性陣發(fā)性位置性眩暈等前庭疾病的發(fā)生幾率。
[Abstract]:The vestibular system plays an important role in maintaining body balance . However , because of the deep buried depth and complicated structure of the inner ear , the etiology and pathogenesis of vestibular disorders need to be clarified .

1 . Based on the study of the inner ear structure of guinea pig , the effective method of three - dimensional reconstruction of the inner ear structure of guinea pig was obtained . On the basis of this , the geometric structure was reconstructed by using the data of the semicircular canal structure of the inner ear of a normal person . The frequency of the system was 13.46 Hz , which was much higher than that of the human daily natural frequency and the frequency of clinical rotation test and cold - heat test .

The results show that the mechanical response amplitude and phase of the symmetric semi - regulation tube are equal , the phase difference is 3.14rad , the mechanical response amplitude and the phase of the symmetric semi - regulation tube are equal to each other , so that the stimulus of the symmetric semi - regulation tube is the same .

The results showed that the amplitude of the vibration amplitude on the lateral surface of the horizontal semicircular canal was sensitive to the rotational acceleration , while the phase of the crest vibration was only correlated with the frequency of the external load .

4 . The numerical analysis of the balance mechanism of the vestibular semicircular canal at ambient temperature was carried out . The results showed that cold or hot water or gas was continuously infused at the external auditory canal , and the front semi - regulation tube was excited about 20s after the horizontal semicircular canal was excited about 20s ;
In order to evaluate the function of the anterior and posterior semicircular canal reliably by means of cold - hot test , it is necessary to prolong the time of cold - hot water or gas filling at the mouth of the external ear canal . This rule is applicable to the evaluation of the vestibular semicircular canal function in any head - position cold - heat test .

5 . The function of the lymphatic valve in the anterior vestibular semicircular canal was discussed . After the expansion of the lymphatic valve in the oval capsule , the larger the opening area of the lymphatic valve in the oval capsule , the larger the opening area of the lymphatic valve in the oval capsule , the greater the volume of the inner lymphatic fluid exchanged by the opening , the greater the volume of the inner lymphatic fluid exchanged by the opening , the greater the volume of the inner lymphatic fluid exchanged by the opening , the greater the volume of the inner lymphatic fluid through the opening , the greater the volume of the inner lymphatic fluid through the opening , and the greater the probability of occurrence of vestibular diseases , such as meloniere ' s disease and benign paroxysmal positional vertigo .

【學(xué)位授予單位】：大連理工大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2013
【分類號】：R318.01

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