本文選題：臨床法醫(yī)學(xué) + 經(jīng)顱磁刺激　； 參考：《華中科技大學(xué)》2013年碩士論文

【摘要】：【研究背景】近年來，隨著經(jīng)濟(jì)建設(shè)及交通運(yùn)輸業(yè)的快速發(fā)展，顱腦外傷呈明顯上升趨勢，前期磁刺激對脊髓外傷后TMS-MEP對運(yùn)功功能的評(píng)價(jià)進(jìn)行了實(shí)驗(yàn)的探討，但腦外傷沒有明確的模型和實(shí)驗(yàn)，經(jīng)顱磁刺激（Transcranial magnetic stimulation，TMS）在臨床上被應(yīng)用于治療精神疾病和神經(jīng)功能障礙取得了一些成果，在法醫(yī)臨床學(xué)領(lǐng)域前期試驗(yàn)證實(shí)MEP （motor evoked potential， MEP）波幅同BBB（Basso-Beattle-Bresnahan, BBB）[1]評(píng)分顯著相關(guān)。但是，TMS的安全性問題被提出，表現(xiàn)在TMS實(shí)驗(yàn)動(dòng)物本身及產(chǎn)品應(yīng)用安全性兩個(gè)主要方面。故本文從TMS對動(dòng)物安全和影響的評(píng)估和非預(yù)期效應(yīng)的評(píng)估等二個(gè)方面進(jìn)行了闡述，并對TMS的應(yīng)用提出建議。以期為法醫(yī)臨床鑒定中將TMS-MEP方法應(yīng)用于客觀肌力的檢測的安全性提供實(shí)驗(yàn)數(shù)據(jù)。 【目的】觀察大鼠腦損傷和脊髓損傷后TMS-MEP波形、潛伏期、波幅及運(yùn)動(dòng)功能之間的變化特點(diǎn)，觀察大鼠的各項(xiàng)指標(biāo)，評(píng)估其應(yīng)用的安全性。 【材料與方法】1、健康成年SD大鼠60只，重量200~300克，，隨機(jī)分為正常對照組（10只，其中1只進(jìn)行病理學(xué)觀察）、腦損傷組A（重物打擊組，10只，其中1只進(jìn)行病理學(xué)觀察）、腦損傷組B（TMS刺激組，20只，其中5只進(jìn)行病理學(xué)觀察）、腦損傷及脊髓損傷組（20只，其中1只進(jìn)行病理學(xué)觀察）。2、各組每天分別經(jīng)顱在50%、70%、90%磁刺激強(qiáng)度下記錄腓腸肌的TMS-MEP。觀察實(shí)驗(yàn)過程中大鼠的一般行為學(xué)表現(xiàn)及試驗(yàn)后大鼠的整體健康和一般健康，每組取6只老鼠檢測血液生化指標(biāo)。3、4周后，對大鼠左下肢腓腸肌TMS-MEP結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析，得出大鼠腦外傷后TMS-MEP與運(yùn)動(dòng)功能之間的關(guān)系及該檢測方法的安全的評(píng)價(jià)。 【結(jié)果】 （1）大鼠腦外傷后B組與正常對照組MEP潛伏期、波幅無顯著性變化（P＞0.05）。 （2）腦損傷及脊髓損傷組大鼠MEP波形難以引出。 （3）50%、70%、90%刺激強(qiáng)度下，各組MEP潛伏期縮短、波幅增高。 （4）腦損傷組A與腦損傷組B血液生化指標(biāo)無明顯改變。 （5）腦損傷組B HE染色光鏡下無再出血及明顯水腫。 【結(jié)論】1.TMS-MEP可以對中樞性運(yùn)動(dòng)功能障礙者肌力進(jìn)行客觀評(píng)價(jià)。 2.在一定限定條件下、安全范圍內(nèi)經(jīng)顱磁刺激是一種安全的、無痛的、操作簡便的檢測方法。
[Abstract]:[background] in recent years, with the rapid development of economic construction and transportation and transportation, craniocerebral trauma has an obvious upward trend. The evaluation of TMS-MEP on the function of transport power after spinal cord injury was studied experimentally by magnetic stimulation in the early stage. However, there are no definite models and experiments for traumatic brain injury. Transcranial magnetic stimulation has been applied to the treatment of mental illness and neurologic dysfunction in clinic. A preliminary study in the field of forensic clinic confirmed that the amplitude of MEP motor evoked potentialwas significantly correlated with BBBBasso-Beattle-Bresnahan (BBB1) score. However, the safety problem of TMS has been put forward, which is manifested in two main aspects: TMS laboratory animal itself and product application safety. In this paper, the assessment of animal safety and effect and the evaluation of unexpected effects of TMS are discussed, and some suggestions on the application of TMS are put forward. In order to provide experimental data for the application of TMS-MEP method in objective muscle strength detection in forensic clinical identification. [objective] to observe the changes of TMS-MEP waveform, latency, amplitude and motor function after brain and spinal cord injury in rats, and to evaluate the safety of its application. [materials and methods] 1. 60 healthy adult SD rats weighing 200,300 g were randomly divided into normal control group (n = 10) and brain injury group (n = 10). One of them was observed by pathology, 20 rats were treated with B(TMS stimulation in brain injury group, 5 of them were observed by pathology, and 20 rats were treated with brain injury and spinal cord injury. Pathological observation was performed on one of them. TMS-MEP of gastrocnemius muscle was recorded in each group under 90% magnetic stimulation. The general behavior of the rats and the overall and general health of the rats after the experiment were observed. The blood biochemical indexes of 6 rats in each group were measured for 4 weeks. The results of TMS-MEP in the gastrocnemius muscle of the left lower extremity of the rats were analyzed statistically. The relationship between TMS-MEP and motor function after traumatic brain injury in rats and the safety evaluation of this method were obtained. [results] 1) there was no significant change in the latency and amplitude of MEP between group B and control group after traumatic brain injury (P > 0.05). 2) the MEP waveform of rats with brain injury and spinal cord injury was difficult to elicit. The latency and amplitude of MEP in each group were shortened and increased under 90% stimulation intensity. 4) there were no significant changes in blood biochemical indexes between brain injury group A and brain injury group B. In the brain injury group, there was no rebleeding and obvious edema under light microscope with HE staining. [conclusion] 1.TMS-MEP can objectively evaluate the muscle strength of patients with central dyskinesia. 2. Transcranial magnetic stimulation (TMS) is a safe, painless and simple method for detection under certain conditions.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：D919.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 喬清理,王秀宏,王明時(shí);經(jīng)顱磁刺激在大腦皮質(zhì)研究中的應(yīng)用和進(jìn)展[J];生物物理學(xué)報(bào);2001年02期

2 余乾;趙二虎;曹禮靜;趙謙;趙永聚;;轉(zhuǎn)基因動(dòng)物及其產(chǎn)品的安全評(píng)估方法研究進(jìn)展[J];中國生物工程雜志;2012年10期

3 王曉明,龍存國,吳碧華,張國元,李秋茹,趙小瓊,鄭霞清;反復(fù)經(jīng)顱磁刺激安全性的實(shí)驗(yàn)研究(英文)[J];中國臨床康復(fù);2003年13期

4 方征宇;尤春景;;經(jīng)顱磁刺激技術(shù)在神經(jīng)康復(fù)領(lǐng)域的應(yīng)用[J];中國醫(yī)療器械信息;2010年02期

5 陳代進(jìn);邱麗萍;劉均連;;重復(fù)經(jīng)顱磁刺激輔助治療抑郁癥療效觀察[J];中外婦兒健康;2011年06期

6 孫東華;;多發(fā)性硬化(MS)的診斷和治療[J];中國現(xiàn)代藥物應(yīng)用;2011年17期

7 藺俊斌;廖維靖;王樸;李華鋼;郭毅;;低頻重復(fù)經(jīng)顱磁刺激治療重性抑郁障礙有效性和安全性的系統(tǒng)評(píng)價(jià)[J];中國循證醫(yī)學(xué)雜志;2011年10期

相關(guān)博士學(xué)位論文 前1條

1 馬雋;磁刺激對小鼠原代海馬神經(jīng)元突觸形態(tài)、突觸蛋白及BDNF-TrkB信號(hào)通路表達(dá)的影響[D];河北醫(yī)科大學(xué);2012年

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