本文關(guān)鍵詞： 內(nèi)淋巴積水 前庭器 膜半規(guī)管 三維重建 流固耦合 生物力學(xué)　出處：《復(fù)旦大學(xué)》2012年博士論文　論文類型：學(xué)位論文

【摘要】：人和哺乳動(dòng)物的內(nèi)耳由骨迷路和膜迷路兩套復(fù)雜管道組成,其中膜迷路內(nèi)充滿內(nèi)淋巴液,并含有位覺感受器(前庭器)和聽覺感受器(耳蝸)。前庭器由三個(gè)半規(guī)管、橢圓囊和球囊組成,感受自身運(yùn)動(dòng)狀態(tài)及頭部在空間位置,并與身體的平衡調(diào)節(jié)有關(guān)。半規(guī)管是頭部角加速度感受器,機(jī)械刺激是前庭器感知頭部位置變化的始動(dòng)因素。內(nèi)淋巴積水(endolymphatic hydrops, EH)是由于各種原因?qū)е聝?nèi)淋巴產(chǎn)生過多或吸收障礙引起的內(nèi)耳膜迷路內(nèi)淋巴液增多,又稱膜迷路積水。梅尼埃病(Meniere's disease, MD)是一種特發(fā)性膜迷路積水綜合征,臨床表現(xiàn)為反復(fù)發(fā)作性眩暈,感音神經(jīng)性聽力下降,耳鳴和耳脹悶感。一般認(rèn)為其病因和發(fā)病機(jī)制與EH密切相關(guān)。EH可引起蝸管、球囊、橢圓囊的膨脹。蝸管的膨脹可能改變基底膜振動(dòng)的行波方式,影響MD患者的聽力,而半規(guī)管、橢圓囊的膨脹是否影響膜半規(guī)管內(nèi)淋巴液與壺腹帽的相互作用,導(dǎo)致MD患者產(chǎn)生前庭癥狀,尚未見文獻(xiàn)報(bào)道。 本研究在光鏡和電鏡下觀察正常和EH對(duì)豚鼠前庭終器的形態(tài)學(xué)影響,發(fā)現(xiàn)豚鼠外膜半規(guī)管壺腹嵴毛細(xì)胞纖毛束(hair cell bundles, HBC)的損傷存在明顯的區(qū)域差別,外半規(guī)管壺腹嵴嵴頂和橢圓囊斑微紋處的HBC損傷最為嚴(yán)重。在Micro-CT圖像清晰顯示前庭器膜性壁的基礎(chǔ)上進(jìn)行三維(three-dimensional,3D)重建,觀察豚鼠前庭器結(jié)構(gòu)的形態(tài)、空間位置及相互毗鄰關(guān)系；測(cè)量外膜半規(guī)管和橢圓囊在垂直于流體流動(dòng)方向橫斷面的管徑,結(jié)果顯示外膜半規(guī)管橫斷面為橢圓形,其長(zhǎng)徑和短徑之比恒定；橢圓囊和壺腹長(zhǎng)徑與短徑之比明顯大于外膜半規(guī)管。EH豚鼠橢圓囊和外膜壺腹的管徑明顯增大,而外膜半規(guī)管管徑無明顯改變,該模型為研究?jī)?nèi)淋巴液在外膜半規(guī)管和橢圓囊的流動(dòng)特征、內(nèi)淋巴液與壺腹嵴的相互作用提供了形態(tài)幾何參數(shù)。 借助逆向工程軟件Geomagic Studio對(duì)MIMICS重建輸出的3D表面模型進(jìn)行去除毛噪、修補(bǔ)和曲面優(yōu)化等處理,分別建立前庭膜迷路、外膜半規(guī)管和橢圓囊的三維幾何模型。根據(jù)外膜半規(guī)管和橢圓囊各部分的管徑測(cè)量結(jié)果,建立正常和EH豚鼠外膜半規(guī)管和橢圓囊二維(two-dimensional,2D)有限元模型,分析正常和EH豚鼠頭部旋轉(zhuǎn)過程中內(nèi)淋巴液與壺腹帽的流固耦合作用,結(jié)果顯示由于內(nèi)淋巴液的慣性作用而滯后于半規(guī)管的運(yùn)動(dòng)而引起壺腹帽的變形,產(chǎn)生的位移和剪切應(yīng)變有所不同。提示壺腹帽剪切應(yīng)變可能是帶動(dòng)壺腹嵴毛細(xì)胞纖毛偏轉(zhuǎn)的主要因素,EH豚鼠橢圓囊和半規(guī)管壺腹的膨大導(dǎo)致壺腹帽剪切應(yīng)變的增加或振幅增大,可能是EH豚鼠壺腹嵴嵴頂HBC損傷的重要原因之一 本研究探討EH對(duì)豚鼠前庭器形態(tài)和功能的影響,利用外膜半規(guī)管2D有限元模型,模擬EH豚鼠在頭部水平旋轉(zhuǎn)運(yùn)動(dòng)過程中,內(nèi)淋巴液和壺腹帽的流固耦合作用,分析外膜半規(guī)管壺腹嵴HBC受損的力學(xué)因素。EH后豚鼠球囊、橢圓囊和膜壺腹存在不同程度的膨脹,而膜半規(guī)管未見明顯改變。EH對(duì)豚鼠外半規(guī)管壺腹嵴HBC的損傷在嵴頂最為明顯。壺腹帽的最大剪切應(yīng)變集中在壺腹嵴嵴頂附近,EH時(shí)明顯增加。EH時(shí)橢圓囊和壺腹的膨脹,影響了內(nèi)淋巴液對(duì)壺腹帽的作用,壺腹嵴嵴頂附近壺腹帽的剪切應(yīng)變的增大或振幅增加,可能導(dǎo)致此處HBC的損傷。上述研究結(jié)果有助于理解EH發(fā)生發(fā)展過程中前庭器損傷的力學(xué)因素,加深對(duì)前庭的病理生理過程的認(rèn)識(shí)。
[Abstract]:Human and mammalian inner ear membranous labyrinth and bone lost by two sets of complex pipes, the membranous labyrinth filled with endolymph, and contains statoreceptor (vestibular) and auditory receptors (cochlea). The vestibular apparatus is composed of three semicircular canals, utricle and saccule, feel the body and head in motion the spatial location, and associated with the balance of the body. The head is semicircular adjustment angle acceleration sensor, mechanical stimulation is initiating factors of vestibular perception changes in head position. Endolymphatic hydrops (endolymphatic hydrops EH) is due to various reasons caused by the inner ear membrane endolymphatic excessive or absorption disorders caused by lost endolymph increased. Also called hydrolabyrinth. Meynier's disease (Meniere's disease MD) is an idiopathic hydrolabyrinth syndrome, the clinical manifestations of recurrent vertigo, sensorineural hearing drop, tinnitus and ear swelling stuffy Generally the etiology and pathogenesis of the disease is closely related with EH.EH can be caused by balloon expansion, cochlear duct, utricle. Expansion wave may change the way the basilar membrane vibration of the cochlea, semicircular canal and effect of MD patients, the hearing, the utricle would not affect the interaction of semicircular duct expansion in lymph fluid and ampulla cap that leads to the generation of vestibular symptoms in patients with MD has not been reported in the literature.
This study observed the effect of normal morphology and EH on vestibular organs of guinea pigs under light microscope and electron microscope, found in guinea pig outer membrane semicircular canal crista hair cell stereociliary bundles (hair cell, bundles, HBC) there are significant regional differences in damage, HBC damage and lateral semicircular canal crista crest utricle striola at most serious. Based on the three-dimensional Micro-CT images clearly show the vestibular membrane on the wall (three-dimensional, 3D) reconstruction, were observed in the guinea pig vestibular structure morphology, spatial location and adjacent relationship; measurement of semicircular duct and utricle in the direction perpendicular to the fluid flow cross-sectional diameter, results show that the lateral semicircular duct cross-section is oval the long diameter and short diameter ratio constant; utricle and ampulla of long and short diameter ratio is significantly greater than the outer canal.EH utricular and ampulla Vater diameter increased significantly, while the outer half There is no significant change in the diameter of the tube. This model provides a morphological parameter for studying the flow characteristics of the inner lymph in the semicircular canal and the utricle of the outer membrane, and the interaction between the inner lymph and the ampullary crest.
To remove noise by 3D hair surface model of reverse engineering software Geomagic Studio MIMICS to reconstruct the output, repair and optimization processing, respectively establish the vestibular labyrinth, a three-dimensional geometric model of semicircular duct and utricle. According to each part of the utricle and semicircular duct diameter measurement results, the establishment of normal and EH guinea pig semicircular duct and ellipse sac (two-dimensional, 2D) two-dimensional finite element model, analysis of the role of EH and normal guinea pig head rotation during the endolymph and cupula the fluid solid coupling. The results show that due to the inertia of the endolymph by behind the movement caused by the deformation of semicircular canal cupula, displacement and shear strain caused by different tips. Ampulla cap shear strain may be a major factor driving the crista of cilia deflection, EH utricular and semicircular canal enlargement caused cupula shear The increase of strain or amplitude may be one of the important reasons for the HBC damage to the crest of the crest of the ampullary crest of EH guinea pigs
This study investigated the effects of EH on the morphology and function of vestibular apparatus, using semicircular duct 2D finite element model, simulation of EH in guinea pig head horizontal rotation process, effects of endolymph and cupula the fluid solid coupling analysis of outer membrane, semicircular canal crista HBC damage mechanics factor.EH of guinea pigs after saccule, utricle and membrane there are different degrees of swelling of membrane, and semicircular canal had no obvious change.EH canal of guinea pig crista ampullaris lateralis HBC damage in crest is most obvious. The maximum shear strain of the cap is located near the crista crest, significantly increased.EH EH expansion utricle and ampulla, affect the function of endolymph of ampulla the cap of the crista ampullaris crest shear strain near the cupula increased or increased the amplitude, here may lead to HBC damage. The research results are helpful to understand the vestibular damage process of the occurrence and development of EH The mechanical factors deepen the understanding of the pathophysiological process of the vestibule.

【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2012
【分類號(hào)】：R764

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