臺灣博碩士論文加值系統

臍帶血移植結果高度仰賴造血幹細胞個數，像是CD34陽性細胞、有核細胞(TNC)、臍帶血體積以及血小板。而捐贈者的相關人口學變項有益於對預測造血幹細胞個數。在這研究中，臍帶血資料來自佛教慈濟幹細胞2007.1.1~2007.12.31的1590筆臍帶血資料。我們去建構預測模式關於母親與嬰兒變項，像是懷孕週數、生產方式、母親年齡、嬰兒出生體重、性別、臍帶長度、胎盤重量與臍帶血生物指標之間的關係。相關分析當中，結果顯示CD34細胞數與TNC、臍帶血體積、血小板彼此間都有顯著性相關。剖腹產的嬰兒其臍帶血當中有較高的CD34細胞數與臍帶血體積，但TNC細胞數與血小板反而較少。女嬰的臍帶血裡有較多的TNC細胞數與血小板，但相反的臍帶血體積就會越少。母親的生產次數越少，臍帶血體積則會相對增加。複迴歸分析方面，懷孕週數越長，那麼CD34細胞數就會減少，相反地TNC細胞數與臍帶血體積則會增加。而胎盤重量較重的臍帶血，臍帶血體積也會相對增加。母親與嬰兒變項會影響到臍帶血之臍帶血移植效益。希望這樣的發現能給予大家初步瞭解臍帶血可能受到之人口學變項有哪些，提供往後研究更深入的探索依據。

The engraftment outcome of umbilical cord blood (CB) transplantation is highly dependent on hematopoietic stem cell content including some laboratory parameters such as CD34, and total nucleated cell (TNC). It would be helpful to predict CB cell count based on the donor-related variables before cell processing. In this study, a total of 1589 CBs preceded from January 2007 to December 2007 were obtained from the Buddhist Tzu Chi Stem Cells Center. We studied the effect of maternal variables such as number of gestation weeks, delivery method, mother’s age, birth order on CB characteristics. Besides, neonatal factors including baby’s sex, birth weight, cord length, and placental weight were evaluated. The mean of CD34, TNC, cord blood volume and platelet were 28.63(10^3/ul), 88.02(10^3/ul), 93.26(ml), and 222.67(10^3/ul), respectively. CB characteristics were correlated significantly. In multiple regression analysis, mother age and cord length had no effect on these CB characteristics, however, delivery method and gender of newborn significantly affected CB characteristics. The results also indicated that the significant factors influencing CD34 were gestation week and placental weight. For TNC, the significant factors were birth order and gestational week. The gestational week, birth weight and placental weight had significant effect on the volume. Those findings might be useful for consideration to collect more qualified CB units efficiently.

中文摘要 i
英文摘要 ii
第一章 緒論 - 1 -
第一節 研究動機與背景 - 1 -
第二節 研究目的 - 1 -
第二章 文獻回顧 - 2 -
第一節 臍帶血移植背景 - 2 -
第二節 造血幹細胞特性 - 4 -
第三節 造血幹細胞影響因子 - 7 -
一、CD34之影響因子 - 7 -
二、TNC之影響因子 - 9 -
三、臍帶血體積之影響因子 - 12 -
第三章 研究材料與方法 - 14 -
第一節 資料申請 - 14 -
第二節 資料分析 - 15 -
第四章 生化指標影響因素分析結果 - 18 -
第一節 描述性統計 - 18 -
第二節 生化指標之相關性 - 20 -
第三節 生化指標與影響因子之相關分析 - 23 -
第五章 結論與討論 - 42 -
附錄 49
附件一、造血幹細胞之分化 49
附件二、IRB審查通過證書 50
附件三、影響CD34細胞數之複迴歸分析（Cp作為篩選依據） 51
附表四、影響TNC細胞數之複迴歸分析 52
附表五、影響臍帶血體積之複迴歸分析 53
附表六、影響血小板之複迴歸分析 54
附表七、影響CD34、TNC細胞數之複迴歸模型比較 55
附表八、影響臍帶血體積、血小板之複迴歸模型比較表 56
附件九、CD34細胞數常態分佈檢定 57
論文SAS分析程式碼 59
R 語法 62

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