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研究生:滕文豹
研究生(外文):Teng-wen Bao
論文名稱:運動處方介入對代謝症候群患者脂肪素和冠狀動脈鈣化指數之影響
論文名稱(外文):The effect of exercise prescription on adipocytokibne and coronary artery calcium score in metabolic syndrome patients
指導教授:林瑞興林瑞興引用關係
指導教授(外文):Jui-Hsing Lin
口試委員:林瑞興
口試日期:2011-06-09
學位類別:碩士
校院名稱:國立屏東教育大學
系所名稱:體育學系
學門:教育學門
學類:專業科目教育學類
論文種類:學術論文
論文出版年:2011
畢業學年度:99
語文別:中文
論文頁數:69
中文關鍵詞:運動處方脂肪素冠狀動脈鈣化指數代謝症候群
外文關鍵詞:coronary artery calcium scoreadipocytokibneexercise prescriptionmetabolic syndrome
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目的:代謝症候群疾病與腹部肥胖、血脂異常、胰島素阻抗和高血壓等因素有關,且終將導致罹患冠狀動脈疾病的機率增加,目前以量化電腦斷層掃描測量代謝症候群患者和冠狀動脈疾病患者的冠狀動脈鈣化指數較為新穎。最近也漸有研究關注到脂肪素與代謝症候群疾病的關係,我們的主要目的是針對代謝症候群患者,給予三個月的運動處方訓練並比較運動前後測之脂肪素及冠狀動脈鈣化指數的影響。
方法:從屏東基督教醫院新陳代謝科門診病患中篩選召募25名受試者依個人意願分派至運動組15名、控制組10名。受試者平均年齡56.7±8.5歲,身高為162±8.5公分,體重是80.1±20.9公斤,經三個月運動處方訓練後,運動組的血液脂肪素、冠狀動脈鈣化指數、血液生化值之前測及後測分別為:Adiponectin (6400.6±3307.3、7306.7±2938.1 ng/dl ),RBP-4(36250.6±15399.9、32687.2±14227.9 ng/dl),Vaspin(0.3±0.2、0.3±0.2 ng/dl);Main LCA(31.2±113.6、28.5±108.6),LAD(24.5±53.3、20.2±33.9),CRX(18.5±59.5、19.4±56.3),RCA(28.8±91.6、23.8±73.5),TOTAL(103.1±271.9、92.0±239.4);HDL-C(41.1±5.9、45.8±5.2 mg/dl),LDL-C(101.0±31.2、102.0+48.7 mg/dl),Cholesterol(176.1±31.5、184.4±72.2 mg/dl),TG(95.0±34.7、151.0±67.1 mg/dl),Glucose AC(160.2±54.8、143.0±44.5 mg/dl),HBA1c(7.7±1.6、7.1±1.0 mg/dl),GPT( 33.5±28.7、36.6±20.5 mg/dl)。並以二因子混合設計(組別×時間)變異數分析考驗運動訓練介入的效果,統計上的顯著水準均定為
α= .05。
結果:運動組經過三個月的運動介入,其脂聯素(adiponectin)數值有增加,視黃醇結合蛋白質-4 (retional binding protein-4,RBP-4)有下降,腹腔脂肪型絲氨酸蛋白酶抑制劑(Vaspin)的數值持平。在運動組
前測及後測的比較,未達統計學上之顯著差異水準。運動組冠狀動脈鈣化指數沒有明顯的改變。三個月運動訓練介入對脂肪素及冠狀動脈鈣化指數在統計學上未達顯著改善效果。
結論:代謝症候群患者之脂肪素及冠狀動脈鈣化指數經過12週的運動介入,在統計學上呈現無顯著差異。
Purpose:Metabolic syndrome (MS) is associated with abdominal obesity, blood lipid disorders, insulin resistance, hypertension and increased risk of developing coronary artery disease (CAD). The ability to measure coronary artery calcium score (CCS) is an urgent topic in risk factor of MS and CAD. Quantitative computed tomography (QCT) is a reliable way to measurement CCS. Recently, a growing amount of evidence suggests that adipocytokibne (adiponectin, retional binding protein-4, vaspin) may be associated with metabolic syndrome. The aim of our reserch want to compare CCS and adipocytokibne in the MS subject at pre-test and post-test after three months exercise prescription.
Material and Method:Total MS subjects estimated to be 25 persons recruited from OPD in metabolic department of PTCH and assigned two groups E and C(exercise, n=15, control, n=10). The mean general deta about 56.7±8.5 years, 162.0±8.5cm, 80.1±20.9kg was noted. After three months exercise training, the pre-test and post-test of Adipocytokine, CCS, and blood biochemistry in group E were: Adiponectin (6400.6±3307.3、7306.7±2938.1 ng/dl),RBP-4(36250.6±15399.9、32687.2±14227.9 ng/dl),Vaspin(0.3±0.2、0.3±0.2 ng/dl);Main LCA(31.2±113.6、28.5±108.6),LAD(24.5±53.3、20.2±33.9),CRX(18.5±59.5、19.4±56.3),RCA(28.8±91.6、23.8±73.5),TOTAL(103.1±271.9、92.0±239.4);HDL-C(41.1±5.9、45.8±5.2 mg/dl),LDL-C(101.0±31.2、102.0+48.7 mg/dl),Cholesterol(176.1±31.5、184.4±72.2 mg/dl),TG(95.0±34.7、151.0±67.1 mg/dl),Glucose AC(160.2±54.8、143.0±44.5 mg/dl),HBA1c(7.7±1.6、7.1±1.0 mg/dl),GPT( 33.5±28.7、36.6±20.5 mg/dl): Two-way analysis of variance (group×time) with repeated measures was used to examine any change after exercise prescription intervention. The statistical significance was determined p< 0.05.
Result:The elevation number of adiponectin in the Group(E) was noted after 3 months exercise training. At the same time, the descending number of the RBP-4, no change in the Vaspin in the Group(E) was also seen. No significant statistical change compared to pre-test and post-test in the Group(E). No obvious improvement CCS in the Group(E) was demonstrated. It was noted that no statistical significant change post three months exercise prescription in the CCS and adipocytokibne.
Conclusion:It was no statistical significant change in the CCS, adipocytokibne after 12 weeks excersie training in MS.
中文摘要……………………………………………………………… I
英文摘要…………………………………………………………… III

目錄…………………………………………………………………… V
表次………………………………………………………………… VII
圖次………………………………………………………………… VIII
第壹章 緒論
第一節 研究背景………………………………………………… 1
第二節 研究的重要性…………………………………………… 3
第三節 研究目的………………………………………………… 3
第四節 研究範圍與限制………………………………………… 3
第五節 名詞定義解釋…………………………………………… 4
第貳章 文獻探討
第一節 代謝症候群之病因及發展……………………………… 7
第二節 運動訓練介入對脂肪素變異之影響…………………… 9
第三節 運動訓練介入對冠狀動脈鈣化指數(CCS)之影響… 12
第四節 本章總結 …………………………………………………14
第參章 研究方法
第一節 研究對象………………………………………………… 15
第二節 研究時間與地點………………………………………… 15
第三節 研究工具………………………………………………… 16
第四節 研究架構………………………………………………… 17
第五節 測試方法和訓練方法…………………………………… 18
第六節 統計方法………………………………………………… 22
第肆章 結果
第一節 受試者基本資料……………………………………… 23
第二節 運動介入對代謝症候群血液生化的影響…………… 24
第三節 運動介入對代謝症候群血液脂肪素的影響………… 25
第四節 運動介入對代謝症候群冠狀動脈鈣化指數的影響… 26
第伍章 分析與討論
第一節 運動介入對代謝症候群血液生化的影響…………… 27
第二節 運動介入對代謝症候群血液脂肪素的影響………… 30
第三節 運動介入對代謝症候群冠狀動脈鈣化指數的影響… 36
第陸章 結論與建議
第一節 結論…………………………………………………… 41
第二節 建議…………………………………………………… 42
參考文獻
中文部分……………………………………………………………… 43
英文部分……………………………………………………………… 45
附錄一 受試者同意書………………………………………… 49
附錄二 人體試驗IRB初審案申請表………………………… 52
附錄三 研究成員保密協議書………………………………… 56
附錄四~六 二因子混合設計變異數分析摘要表………………… 57
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