臺灣博碩士論文加值系統

子宮內膜異位症是子宮內膜出現在子宮腔外的現象，為育齡婦女常見的問題，且可影響生育力。近年來研究認為可能是環境因素作用所導致之表現型。國外研究顯示，來經較早、經期較短、行經期較長、經痛、瘦高體型、喝酒、咖啡、長時間使用子宮內避孕器及環境賀爾蒙等都是危險因子。這些因子是否導致氧化壓力造成細胞傷害，環境賀爾蒙是否干擾內分泌使危險性增加，都未獲釐清。本研究係探討子宮內膜異位的危險因子，及生活或環境中的暴露是否會影響人體的氧化壓力，進而造成子宮內膜異位。
本研究為橫斷研究法，共收取207個不孕症的初診個案。並排除先前已經過子宮內膜異位治療的婦女。收集個案之問卷，子宮內膜異位的判定結果，以及血液檢體進行脂質過氧化物質（MDA）、抗氧化能力（GSH）、金屬元素（Pb、Cd、Hg、Cr、Mn、Se、Cu、Zn、Fe）分析。
分析具有子宮內膜異位之個案EN（+）54位，不具有子宮內膜異位之個案EN（-）153位結果：婚姻狀況在EN（+）和EN（-）的分佈有達統計上的顯著差異，其餘的基本人口學資料皆未達統計上顯著差異。而月經狀況在EN（+）和EN（-）的分布也達統計上顯著差異。EN（+）在巧克力囊腫、人工流產（P=0.0180）以及經期不規則（P=0.0122）等達統計上顯著差異。
而氧化壓力的指標在EN（+）上，MDA的濃度較高，GSH的濃度較低。但皆未達統計上差異。本研究結果亦發現，子宮內膜異位婦女體內血中鋅、硒濃度顯著低於不具有子宮內膜異位的婦女。

目錄
第一章 緒論.....................................................9
第一節 研究背景與動機........................................9
第二節 研究目的與假設.......................................10
第三節 研究架構.............................................11
第二章 文獻探討................................................12
第一節 子宮內膜異位.........................................12
第二節 動情素...............................................13
第三節 體內氧化能力與抗氧化能力.............................18
第四節 金屬元素.............................................24
第三章 材料與方法..............................................35
第一節 研究流程.............................................35
第二節 研究對象與資料收集...................................36
第三節 實驗方法.............................................37
第四節 資料處理與統計分析...................................50
第四章 研究結果................................................51
第一節 基本描述性統計.......................................51
第二節 疾病史...............................................58
第三節 氧化壓力、抗氧化能力與各變項之相關...................63
第五章 討論與結論..............................................74
第一節 子宮內膜異位之盛行率與危險因子.......................74
第二節 子宮內膜異位與體內氧化壓力...........................76
第三節 研究限制.............................................79
第四節 結論與建議...........................................80
參考文獻.......................................................80
表目錄
Table2-1-1 子宮內膜異位症狀……………………………………………………15
Table2-1-2 子宮內膜異位其它危險因子…………………………………………16
Table2-2-1 子宮內膜異位與雌激素………………………………………………18
Table2-3-1氧化壓力與子宮內膜異位…………………………………………….23
Table2-3-2其他因子與氧化壓力………………………………………………….24
Table2-4-1鉛與雌激素…………………………………………………………….30
Table2-4-2 鎘與雌激素…………………………………………………………….31
Table2-4-3 汞與雌激素…………………………………………………………….32
Table2-4-4 鉛與氧化壓力………………………………………………………….33
Table2-4-5 鎘與氧化壓力………………………………………………………….34
Table2-4-6 汞與氧化壓力………………………………………………………….35
Table3-3-1ICP-MS參數設定……………………………………………………….50
Table4-1-1 基本人口學變項-1 ………………………………………...………….55
Table4-1-2 基本人口學變項-2 ……………………………………………………56
Table4-1-3生活習慣分布…………………………………………………..………58
Table4-2-1慢性疾病史……………………………………………………..………61
Table4-2-2婦科疾病史……………………………………………………..………62
Table4-2-3懷孕狀況………………………………………………………..………64
Table4-3-1氧化壓力與子宮內膜異位之關係……………………………..………68
Table4-3-2金屬濃度在個案間分布…………………………………………..……68
Table4-3-3人體生化值分布……………………………………………………..…69
Table4-3-4氧化壓力與生活習慣………………………………………………..…70
Table4-3-5-1生活習慣與金屬濃度-1………………………………………...……71
Table4-3-5-2生活習慣與金屬濃度-2…………………………………………72
Table4-3-6氧化壓力與其他因子之迴歸模式…………………………...…...73
Table4-3-7各變項間之斯皮曼相關係數…………………………………..…74
Table4-3-8子宮內膜異位與其他因子之邏輯斯迴歸模式……………….…75

圖目錄
圖2-1-1 婦女生殖系統示意圖……………………………………..…………12
圖2-1-2 子宮內膜異位常見發生部位…………………………….…………13
圖2-1-3 腹腔鏡示意圖………………………………………………………15
圖2-3-1 ROS造成細胞傷害的機制…………………………………………21
圖2-3-2 子宮內膜異位和氧化壓力示意圖…………………………………22
圖3-4- 1 MDA標準品在波長586 nm下之檢量線圖………………………42
圖3-4- 2 GSH標準品在波長400 nm下之檢量線圖……………………… .45

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