腦血管疾病一直對人類造成嚴重的威脅，其造成的傷害除了個人外，也 對於患者家庭形成衝擊，因此對此疾病的預防以及發生後的治療便相當重 要。由於在臨床上對於中風缺乏較有效率的即時治療方法，所以引起的病 狀和死亡是常見的結果，目前許多的研究計畫多致力於尋找出腦神經細胞 的死亡機轉，期望能藉此尋找出新藥物化合物可促進控制腦細胞缺血所引 起的腦神經細胞損傷。
在先前的研究中顯示褪黑激素具由神經保護的功能，而再本次學習中吾 人更進一步由分子層面觀察褪黑激素對於神經保護的功能，並且藉由 GAP43 蛋白的表現情形，得到褪黑激素除具備神經保護的能力外，同時也 可能具有神經再塑的潛力。
因此未來期待更進一步的探討其機制的方向，藉由瞭解其機制增加其在 臨床上的運用，希望結合此神經保護藥劑與血拴溶解劑這兩種藥物應用於 治療缺血性腦中風的病人，增加治療的黃金時期與保護神經受損情形。
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附表與附圖
表 1 感覺神經行為檢查評估表
評分 動作狀態
0 立即抓握目標物
1 不完全或延遲抓握目標物 2 完全無法抓握目標物
表 2 運動神經行為檢查評估表
評分 動作狀態
0 無顯著行動上缺陷 1 前肢屈曲
2 前肢屈曲，且較不能抵抗側邊的推力
3 前肢屈曲，較不能抵抗側邊的推力，且身軀繞同一側旋轉 4 前肢屈曲，且較難或無法行走
表 3 MCAO 處理後神經行為評估系統之評量結果
感覺（Sensory） 運動（Motor）
Control group （n=10） 3 ± 0 2 ± 0
Melatonin treated group（n=10） 3 ± 0 2 ± 0
圖1：各組核心體溫與時間關係圖
圖2：同側半球 SⅡ區域局部腦皮質血流監測圖
圖3：同側半球 SⅠ區域局部腦皮質血流監測圖
圖4：對側半球 SⅡ區域局部腦皮質血流監測圖
圖5(A)：腦部冷凍切片經 Nissl 染色後所呈現之結果圖形
Infarction volume
In farctio n volume%
0 10 20 30 40 50 60 70
Control Melatonin
Brain edema
46.4
30.8
3.7 3.8
圖5(B)：腦部冷凍切片梗塞體積及水腫體積計算結果量化圖
圖6(A)：Penumbra 之 SNAP-25 蛋白在西方墨點法之表現圖
圖6(B)：Penumbra 之 SNAP-25 蛋白在西方墨點法之結果量化圖
圖7(A)：Penumbra 之 Synaptophysin 蛋白在西方墨點法之表現圖
圖7(B)：Penumbra 之 Synaptophysin 蛋白在西方墨點法之結果量化圖
圖8(A)：Penumbra 之 GAP43 蛋白在西方墨點法之表現圖
圖8(B)：Penumbra 之 GAP43 蛋白在西方墨點法之結果量化圖
圖9(A)：Ischemic core 之 SNAP-25 蛋白在西方墨點法之表現圖
圖9(B)：Ischemic core 之 SNAP-25 蛋白在西方墨點法之結果量化圖
圖 10(A)：Ischemic core 之 Synaptophysin 蛋白在西方墨點法之表現圖
圖10(B)：Ischemic core 之 Synaptophysin 蛋白在西方墨點法之結果量化圖
圖11(A)：Ischemic core 之 GAP43 蛋白在西方墨點法之表現圖
圖 11(B)：Ischemic core 之 GAP43 蛋白在西方墨點法之結果量化圖