内淋巴吸收障碍至梅尼埃病的生物力学研究及临床应用

Meniere's disease (MD) characterized by paroxysmal vertigo, the volatility of deafness and tinnitus, is a complicated ascites diseases on which the otologists paid high attention.The age range of onset is wide and the cause of disease is unknown. The mainstream theory was that the disease was caused by endolymphatic duct mechanical obstruction and endolymphatic malabsorption. Any part of stenosis and obstruction in the endolymphatic flow path may cause the endolymphatic duct mechanical obstruction and endolymphatic malabsorption and then caused the hydrolabyrinth. This project extract it as the the key issue that under the interaction between the membranous labyrinth structure and the endolymph the mechanical response of the patients’ vestibule and semicircular canal receptors are abnormal. Based on the previous study on the numerical model of membranous labyrinth structure the numerical model of endolymphatic system would be built and the biomechanics research platform for hydrolabyrinth in inner ear would be establised with the medicine and biomechanics interdisciplinary approach. According to the relevant animal experiments and clinical data the pathogenesis that endolymphatic duct mechanical obstruction and endolymphatic absorbing barrier can cause Meniere's disease would be revealed quantitatively from biomechanical point of view.This work can deepen the knowledge of the new risk factors of Meniere's disease and provide the theory and practice foundation for the clinical treatment and prevention.

梅尼埃病（Meniere's disease，MD）一直是耳科专家高度重视的内耳疑难疾病，发作性眩晕、波动性耳聋和耳鸣是其主要症状。其发病年龄范围广，病因不明。目前主流发病学说为内淋巴管机械性阻塞与内淋巴吸收障碍：在内淋巴纵流中任何部位的狭窄和梗阻都可能引起内淋巴管机械性阻塞或内淋巴吸收障碍，是膜迷路积水的主要原因。本项目提取患者内耳膜迷路膜质结构在与内淋巴液之间的耦合作用下，其前庭及半规管感受器力学响应异常这一关键问题，应用医学与生物力学多学科交叉的方法，基于本课题组前期内耳膜迷路的数值模型研究基础，构建较完整的内耳内淋巴系统数值模型，建立针对内耳膜迷路积水膨大的生物力学研究平台，结合相关动物实验和临床资料，从生物力学角度量化揭示内淋巴管机械性阻塞与内淋巴吸收障碍致梅尼埃病的发病机制；加深人们对梅尼埃病致病因素新的认识，为该病医学临床防治提供理论与实践研究基础.

梅尼埃病是以膜迷路积水为主要病理特征的内耳前庭疑难疾病，其主要症状为眩晕、波动性耳聋和耳鸣，其发病机理至今不明。本课题通过生物力学的方法对其发病机理进行了以下研究，1.根据影像学数据和组织切片建立豚鼠内耳迷路结构三维数值模型，从形态学上对正常豚鼠内耳和病态豚鼠内耳结构几何参数进行了统计和对比，发现了正常态内耳和梅尼埃病内耳结构几何尺寸的统计学差异。2.在建立的数值模型的基础上，对正常生理状态和迷路积水膨胀状态下的内耳进行数值模拟，研究了内耳迷路中内淋巴压力传递特性与其几何结构之间的关系以及梅尼埃疾病对该功能的影响。3.在建立的数值模型的基础上，对内耳迷路平衡功能进行了数值模拟研究，并对正常人的内耳迷路平衡功能进行了眼震测试，研究嵴顶变形与眼震之间的关系。同时通过豚鼠进行了内耳迷路积水造模实验，并进行了听力测试，研究梅尼埃病对听力的影响。4.针对梅尼埃病患病机理中内淋巴囊的相关假说，研究了在内淋巴囊功能丧失的情况下，内耳迷路几何结构的变化规律，总结了内淋巴管机械性阻塞与内淋巴吸收障碍至梅尼埃病的致病特征。该研究可以更好地解释内淋巴吸收障碍至梅尼埃病的发病机理，为梅尼埃病的临床诊疗提供数值研究平台。