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研究生:黃明明
研究生(外文):Huang Ming Ming
論文名稱:II期乳癌患者手術後接受輔助性化學和放射治療對血中銅鋅狀態之影響
論文名稱(外文):Effects of Post-operative Adjuvant Chemotherapy and Radiotherapy on Serum Copper and Zinc Status in Stage II Breast Cancer Patients
指導教授:陳玉華陳玉華引用關係
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:保健營養學系
學門:醫藥衛生學門
學類:營養學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:法文
論文頁數:64
中文關鍵詞:乳癌化學治療放射治療超氧歧化酶
外文關鍵詞:Breast cancerChmotherapyRadiotherapyCopperZincSOD
相關次數:
  • 被引用被引用:1
  • 點閱點閱:313
  • 評分評分:
  • 下載下載:28
  • 收藏至我的研究室書目清單書目收藏:1
摘要
台灣地區女性乳癌發生率有逐年增高的趨勢,依民國九十一年衛生署之癌症死因統計資料顯示,女性乳癌已位居癌症死亡原因第四位。所以,本研究主要在探討18位經外科手術後之女性第II期乳癌患者,於接受輔助性化學和放射治療後血中銅、鋅、銅/鋅比值與紅血球SOD的變化,以及患者飲食攝取情形與體重的變化,以了解飲食、化學和放射治療是否影響患者體內微量元素之營養狀態,以作為日後臨床治療之適當營養支持的參考。結果顯示,化學和放射治療前後乳癌患者血中銅、鋅、銅/鋅比值和紅血球SOD無顯著差異。於治療期間銅鋅比值雖無統計差異、但彼此間呈統計正相關的趨勢。飲食中鋅與蛋白質的攝取量與血中銅、鋅濃度無統計相關。化學和放射治療開始後,每日熱量攝取量顯著提高300~100 kcal/d,且患者體重呈現上昇趨勢,,但與治療前無明顯差異。三大營養素的攝取百分比皆在正常的範圍內。蛋白質的攝取量在化學和放射治療開始後,由1.17 g/kg BW提高至1.39 g/kg BW,但治療前後亦無明顯差異。鋅的攝取量在治療期間較治療前高,治療前後無明顯差異,但皆低於RDNA之建議量。總而言之,手術後第II期乳癌患者接受輔助性化學和放射治療時,若攝取均衡且符合銅鋅建議量的飲食,則其血中銅、鋅、銅/鋅比值和紅血球SOD治療前後皆無顯著差異。
關鍵詞:乳癌、化學治療、放射治療、銅、鋅,SOD
Abstract
In Taiwan, the incidence rate of female breast cancer has been increasing gradually every year, and has been the 4th leading cause of cancer death. This study was aimed to explore the effect of postoperative adjuvant chemotherapy (C/T) and radiotherapy (R/T) on serum copper, zinc, Cu/Zn ratio and RBC-SOD in female breast cancer patients. In the meantime, we analyzed the dietary intake and body weight change to understand whether the serum trace elements status of the patients were influenced by diet, C/T, or R/T. Results obtained from this study may provide some information for adequate nutrition support in clinical practice in the future. The results showed that serum copper, zinc, Cu/Zn ratio and RBC-SOD were not significantly different before and after C/T and R/T treatment in patients. During postoperative treatment, Cu/Zn ratio did not show significant difference, but a significantly positive correlation trend between several measurement was noted. Dietary zinc and protein intake did not significantly correlated with serum copper and zinc status. Calorie intake increased 300-100 Kcal/d and body weight showed an elevated trend with 3% increase after the postoperative treatment started, however, there were no obvious changes than before. The percentage of macronutrients intake were in normal ranges. Protein intake increased from 1.17 g/ kg BW to 1.39 g/kg BW when postoperative treatment began, and zinc intake was higher during treatment period, but showed no significant difference. The level of zinc intake was below RDNA before and after treatment. In conclusion, postoperative adjuvant chemotherapy and radiotherapy did not affect serum copper , zinc, Cu/Zn ratio and RBC-SOD in stage II breast cancer patients who take balance diet containing adequate amount of copper and zinc.
Keywords: breast cancer, chemotherapy, radiotherapy, Cu, Zn, SOD
目錄
頁次
第一章 前言------------------------------------------------------------------1
第二章 文獻回顧------------------------------------------------------------3
一、 癌症的介紹--------------------------------------------------------3
二、 乳癌的介紹--------------------------------------------------------5
(一) 乳癌的類型--------------------------------------------------5
(二) 乳癌的診斷--------------------------------------------------6
(三) 乳癌的治療方式--------------------------------------------8
(四) 其他相關研究----------------------------------------------10
1. 飲食與乳癌之相關性---------------------------10
(1)脂肪攝取與乳癌的相關性------------------10
(2)酒精攝取與乳癌的相關性------------------11
(3)phytoestrogens攝取與乳癌的相關性-----12
(4)維生素C、E和A攝取與乳癌的相關性
-------------------------------------------------------13
2. 銅、鋅、Cu, Zn-SOD的生理特性-----------13
(1)銅的生理特性-----------------------------------13
(2)鋅的生理特性-----------------------------------15
(3)Cu, Zn-SOD的生理特性----------------------18
3. 銅、鋅、Cu, Zn-SOD與癌症------------------19
第三章 材料與方法--------------------------------------------------------------22
一、 實驗設計----------------------------------------------------------22
(一) 實驗對象的挑選-------------------------------------------22
(二) 資料收集與實驗項目分析-------------------------------22
1. 銅、鋅的血液分析-------------------------------25
2. SOD的分析----------------------------------------26
3. 飲食的分析----------------------------------------27
二、 統計分析----------------------------------------------------------28
第四章 結果-----------------------------------------------------------------29
一、 實驗受試者之基本資料---------------------------------------29
二、 化學和放射治療期間乳癌患者體重與飲食的變化----31
三、 化學和放射治療期間乳癌患者血中銅、鋅、銅/鋅比值、
SOD的變化---------------------------------------------------33
第五章 討論-----------------------------------------------------------------44
一、 化學和放射治療對乳癌患者血中銅、鋅與SOD之影響----------------------------------------------------------------------44
(一) 化學治療之影響------------------------------------------44
(二) 放射治療之影響------------------------------------------46
二、飲食對接受化學和放射治療之乳癌患者血中銅、鋅與SOD之影響--------------------------------------------------------------------46
三、結論--------------------------------------------------------------------50
參考文獻-------------------------------------------------------------------51
附錄-------------------------------------------------------------------------63
一、飲食記錄------------------------------------------------------------63
二、飲食頻率問卷----------------------------------------------------- 64
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