跳到主要內容

臺灣博碩士論文加值系統

(44.200.86.95) 您好!臺灣時間:2024/05/21 10:01
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:許雅婷
研究生(外文):Ya-Ting Hsu
論文名稱:輻射污染建築物居民血液學指標之長期追蹤資料分析
論文名稱(外文):Longitudinal Data Analysis of the Hematological Changes in Individuals Exposed to Chronic low-dose radiation
指導教授:林逸芬
指導教授(外文):I-Feng Lin
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:公共衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
中文關鍵詞:低劑量輻射血液學指標長期追蹤資料線性平均混合模式無母數迴歸
外文關鍵詞:low-dose radiationhematological indiceslongitudinal dataLinear mixed model with parametric covariance structurenonparametric regression
相關次數:
  • 被引用被引用:0
  • 點閱點閱:190
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
本研究分析輻射污染建築物居民之血液學長期追蹤的變化趨勢,探討輻射累積劑量及遷離時距(搬離輻射屋後到健檢之間的時間)在血液學指標上所扮演的角色。過去台灣輻射屋居民血液學資料的分析族群只集中在相對低劑量的國小輻射污染教室學童,本研究分析年暴露劑量在五毫西弗(mSv)以上且集中於臺大醫院健檢的各年齡層居民有完整累積劑量及遷出紀錄共414人。本研究使用的長期資料統計模式以概率函數估計(likelihood method)的線性平均混合模式(Linear mixed model with parametric covariance structure)為主。共比較五種不同的年齡及性別校正的方法:直接將年齡及性別根據資料以分段線性(piecewise)的方式設定數個虛擬變項放在線性平均混合模式中,以及以性別分層的單變項cubic smoothing splines及Thin-plate smoothing splines兩種無母數迴歸模式分別設定兩種不同自由度平滑參數共五種模式。以無母數迴歸校正年齡及性別後,殘差以長期資料的線性平均混合模式估計後發現,紅血球總數(RBC)、血色素(Hemoglobin)、血球容積比(Hematocrit)、中性白血球(Neutrophil)會隨著遷離時距的增加而緩慢下降。白血球總數(WBC)、平均紅血球容積(MCV)、平均紅血球血色素濃度(MCHC)、血小板(Platelet)會受到遷離時距的增加而緩慢上升。淋巴球(Lymphocyte)跟遷離時距則沒有統計上的顯著相關。台灣輻射累積劑量(TCD)的影響只有在中性白血球(Neutrophil)可以看到TCD在5毫西弗以上的平均比TCD小於5毫西弗的高,有統計上顯著差異。其餘的血球看不到劑量反應關係。若分性別探討與遷離時距的關係,可以發現Hemoglobin、Hematocrit、MCHC、Neutrophil、Platelet上升或下降的速率女性較男性稍快,RBC、WBC、MCV上升或下降的速率男性較女性稍快,Lymphocyte不論男女都沒有統計上的顯著相關。TCD的影響在男性Neutrophil及女性RBC可以看到統計上顯著差異,男性Neutrophil平均增加的速率比女性快,女性RBC平均會下降。另外比較五種有母數迴歸及無母數迴歸的年齡及性別校正方法後,雖然P values不盡相同,但各參數估計值及方向是相當一致的。這些血液學指標的緩慢的變化,可能是身體的一種自然修復,也可能是某些潛伏期較長的疾病或損傷的前兆,將來是否會趨於穩定或繼續變化,這些都需要更長時間的觀察。
The research analyzes the longitudinal effects in hematology of radiation-polluted residents, and discusses the roles of cumulative radiation dose and relocation time (the duration from moving out of the polluted housings to health check up) in hematological indices. In the past, the Hematology data of the Taiwan radiation housing residents was exclusively based on the comparatively lowly dosed primary school students who had been taught in polluted classrooms. Now this research broadens to the different age groups of patients who have done check ups at the National Taiwan University Hospital. The 414 patients have intact cumulated dosage and move records, and have all been exposed to doses over 5mSv. The model for longitudinal data is mainly composed of the Likelihood Method’s Linear mixed model with parametric covariance structure. The different ages and gender adjustment are of the following five: directly place age and gender information in piecewise mode to set multiple dummy variables in the Linear mixed model with parametric covariance structure, and using Cubic smoothing splines and Thin-plate smoothing splines; two kinds of Nonparametric regression models which set two different smoothing parameters. Upon adjusting the ages and genders using the nonparametric regression and residual estimated by the linear mixed model with parametric covariance structure, the research shows that RBC, Hemoglobin, Hematocrit, and Neutrophil were shown to be negatively and significantly associated with the relocation time. On the other hand, WBC, MCV, MCHC, and Platelet were positively associated with the relocation time. However, there is no significant association between the relocation time and Lymphocyte. In other words, the influence of Taiwan’s radiation cumulated dose (TCD) only affects Neutrophil, as significantly association that the average of TCD in exposures above 5mSv is higher than TCD in exposures below 5mSv. Otherwise, there is no significant dose-response effect that exists between the other blood cells. Investigation in gender and the relocation time indicates that Hemoglobin, Hematocrit, MCHC, Neutrophil, and Platelet in women are more prone to move up or down the scale compared men. However, men’s RBC, WBC, and MCV lead the women’s in reaction to time while Lymphocyte appears to have no significant association whether in men or women. The effects on men’s Neutrophil and women’s RBC by TCD are obvious; the average rate of increasing Neutrophil in men is speedier than women’s, and women’s average RBC decreases. Combining with five adjustments of gender and age by nonparametric regression and parametric regression, it is shown that although the P-values vary, the parametric estimates and indications are consistent. These indicators of Hematology’s deliberate progression could be the result of natural healing of body but could also be the early symptoms of injuries or diseases which have long incubation periods. As to if these indicators will continue to evolve or stay as they are, it is a question that will require a much longer period of observation.
1. Chang WP, Lin YP, Hwang PT, Tang JL, Chen JY, Lee SD. Persistent leukocyte abnormalities in children years after previous long-term low-dose radiation exposure. British Journal of Haematology 1999;106:954-959
2. Wang JC, Lin YP, Hwang S, Hsieh WA, Chen JC, Tang JL, Hwang JS, Lu WJ, Chang WP. Late haematological changes in a population exposed to chronic low dose rate radiation during childhood. The British Institute of Radiology 2002;75:44-49
3. Ghossin, N.A. & Stacey, P. The prognostic significance of radiation-related eosinophilia. Radiology 1973;107:631-633
4. Pillai, M.R., Balaram, R. & Bindu, S. Radiation associated eosinophilia and monocytosis in carcinoma of the uterine cervix:a simple clinical and prognostic indicators. Neoplasma. 1990;37:91-96
5. Raben, M., Galili, U. & Schlesinger, M. The effect of radiation therapy on lymphocyte population in cancer patients. Cancer. 1976;37:1417-1421
6. Fuks, Z., Strober, S., Bobrove, A.M., Sasazuki, T., McMichael, A. & Kaplan, M.S. Long-term effects of radiation on T and B lymphocytes in peripheral blood of patients with Hodgkin’s disease. Journal of Clinical Investigation. 1976;58:803-814
7. Trask, C.W.L., Llewellyn, I. & Souhami, R.L. The effect of radiotherapy on blood mononuclear cell numbers and phagocyte migration. Clinical Radiology. 1980;31:733-738
8. Plowman, P.N. The effects of conventionally fractionated, extended, portal radiotherapy on the human peripheral blood count. International Journal of Radiation Oncology, Biology and Physics. 1983;9:829-839
9. Forslund, T., Welin, M.G., Laasonen, L., Weber, T.H. & Edgren, J. Peripheral blood lymphocyte subsets in radiologists exposure to ionizing radiation. Acta Radiologica et Oncologica. 1985;24:415-417
10. Koefler, H.P., Cline, M.J. & Golde, D.W. Splenic irradiation in myelofibrosis: effect in circulating myeloid progenitor cells. British Journal of Haematology. 1979;43:69-77
11. Neriishi, K., Delongchamp, R.R. & Kodoma, K. Chronic preclinical inflammation in atomic bomb surviuors: implication of pstirradiation oxidative stress. Program and Abstracts of Radiation Society and North American Hyperthermia Society 1997;37:91-96
12. Kindzel’skii LP, Zlochevskaia LL, Tsyganok TV, Shabaeva MM. The natural body resistance of the inhabitants of the city of Kiev subsequent to the accident at the Chernobyl Atomic Electric Power Station. Likarska Sprava 1993;4:25-28[In Russian.]
13. Pivnik AV, Moiseeva TN, Domracheva EV, Radi LS, Brouna GA, Karpora IV. The clinico-hematological indices of the participants in the cleanup of the aftermath of the Chernobyl accident. Terapevticheskii Arkhiv 1996;68:73-77[In Russian.]
14. Cardarelli JC, Hornung R, Elliott R, Chang WP. Proposed model for estimating dose to inhabitants of Co-60 contaminated buildings. Health Phys 1997;72:351-360
15. Hwang JS, Chan CC, Wang JD, Chang WP. Radiation exposure modeling for apartment living spaces with multiple radioactive sources. Health Phys 1998;74:379-386
16. Duchon, J. (1976), “Fonctions-Spline et Esperances Conditionnelles de champs Gaussiens,” Ann. Sci. Univ. Clermont Ferrand Ⅱ Math, 14,19-27
17. Duchon, J.(1977) “Splines Minimizing Rotation-Invariant Semi-Norms in Sovolev Spaces,” in Constructive Theory of Functions of Several Variables, eds. W. Schempp and K. Zeller, New York:Springer-Verlag,85-100
18. Meinguet, J. (1979),”Multivariate Interpolation at Arbitrary Points Made Simple,” Journal of Applied Mathematics and Physics(ZAMP),30,292-304
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top