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研究生:鄭靜梅
研究生(外文):Ching-Mei Cheng
論文名稱:探討學齡兒童尿液中三聚氰胺與N-乙醯葡糖胺、Beta-2 球蛋白濃度的相關性
論文名稱(外文):Study of Melamine Exposure with UrinaryN-Acetyl-β-D-Glucosaminidase and Beta2Microglobulin Concentration in School Children
指導教授:吳明蒼吳明蒼引用關係
指導教授(外文):Ming-Tsang Wu
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:職業安全衛生研究所
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:2013
畢業學年度:101
語文別:中文
論文頁數:85
中文關鍵詞:三聚氰胺N -乙醯葡糖胺Beta-2球蛋白學齡兒童
外文關鍵詞:MelamineN-Acetyl-β-D-Glucosaminidaseβ2-MicroglobulinSchool children
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三聚氰胺為本世紀最讓人熟悉的化學物質,2007 年三聚氰胺汙染寵物食品造成寵物腎衰竭、2008 年的含三聚氰胺的毒奶事件等這些事件都可能經由長期累積而在不知不覺中造成腎臟的危害,而禍首:三聚氰胺竟然存在於生活相關的物品如:餐具、玩具等甚至食品中。最近的研究顯示,低劑量的三聚氰胺暴露會提高成人尿路結石的風險,然而,目前尚未有足夠的研究說明兒童暴露低劑量三聚氰胺之健康影響相關的研究。預防保健要從小做起,因此本研究在探討兒童尿中三聚氰胺與腎功能指標(N -乙醯葡糖胺、Beta-2 球蛋白濃度)之間的相關性。目前關於三聚氰胺暴露的研究,都是採檢隨機尿液做三聚氰胺化驗,,尚未有做24 小時尿液檢測的相關研究,更沒有24 小時尿液與隨機尿液腎功能指標兩者的相關研究。有鑑於此,本研究針對24 小時的尿液收集並與隨機單點尿液檢測比較學童尿液中三聚氰胺與N -乙醯葡糖胺、Beta-2 球蛋白濃度。本研究徵求學齡兒童(國小)共23 位,並收集其24 小時的尿液與隨機單點尿液,分別分析其尿液中三聚氰胺與N -乙醯葡糖胺、Beta-2 球蛋白濃度,由於Beta-2 球蛋白於有96%樣本低於偵測極限所以不於以評估。其他分析結果經校正後,可發現在第一天與第二天早上的第一泡尿液(spot 1
與spot 2)以及8 小時與24 小時,皆存有顯著性相關(P<0.05);在spot 1 與spot 2 以及8 小時與24 小時尿液分析中三聚氰胺與N -乙醯葡糖胺濃度相互比較,則不具顯著性相關。實驗結果顯示,用隨機單點尿液樣本分析三聚氰胺是可行的,但尿中N-乙醯葡糖胺濃度均會受飲水、飲食、姿勢、運動等因子影響,這些因素對於臨床診斷判定都是必頇要考慮進去的。本研究目前尚無發現尿液中三聚氰胺與N -乙醯葡糖胺、Beta-2球蛋白濃度具有相關性,由於個案數小故仍需收集更多個案數進行分析,來做為研究之佐證。

Many people were familiar with the chemical melamine in 21st Century. In 2007, an outbreak of nephrotoxic renal failure and death occurred in dogs and cats in North America.In 2008 an outbreak of renal stones associated with
consumption of melamine-tainted milk products in infants and young children in China. Recently, epidemiological studies show that exposure to low doses of melamine increased the risk of adult urinary tract stones. Except for daily foods, plastic and toy have been widely contaminated with melamin. To date, there is limited data regarding the effects of low doses of melamine exposure and
children''s health, i.e., renal injury remain unclear.
Most of the studies use spot urine to measure melamine exposure and clinical measurement of kidney function. This study was conducted 24 hour urine and spot urine to creatinine ratio of urinary melmaine as melamine exposure and N-Acetyl-β-D-Glucosaminidase and Beta2 Microglobulin as
kidney function assessment among 23 children.
The results show that whether urinary melamine or
N-Acetyl-β-D-Glucosaminidase and β2-microglobulin, the first morning urine of two days (spot1 and spot2), and 8 hours and 24 hours had significant correlation (p<0.05); however, when we compared the urinary melamine、
N-Acetyl-β-D-Glucosaminidase and in spot1, spot2, or 8 hours and 24 hours,the results show no significant correlation. β2-microglobulin concentration in
the majority of urine samples over 96% was below the limitations,this marker was not analyzed subsequently.
The results show that spot urine collection to determine melamineis possible, but for kidney function marker, the interference of the metabolism of the body factor and also varience by the water, exercise and others. These factors in the clinical diagnosis must be taken into account. These data suggest that we need further study to explore the relationship between urinary melamine 、N-Acetyl-β-D-Glucosaminidase and β2-Microglobulin.

摘要 ..................................................... I
ABSTRACT ............................................... II
目錄.................................................... III
表目錄.................................................... V
圖目錄................................................... VI
第一章 緒論 ............................................... 1
第一節、 研究動機 .......................................... 1
第二節、 研究目的............................................2
第二章 文獻回顧 ............................................ 3
第一節、 三聚氰胺的簡介 ..................................... 3
第二節、 三聚氰胺的毒性 ..................................... 6
第三節、 腎病變早期生物偵測指標 .............................. 14
一、 腎臟的生理學 ......................................... 14
二、 N-Acetyl-β-D-Glucosaminidase(NAG) .................. 15
三、 β2-微球蛋白β2-microglobulin(β2M) ..................... 16
第三章 材料與方法 .......................................... 19
第一節、 儀器與試藥......................................... 19
一、 儀器 ................................................ 19
二、 試藥 .......................................................................................... 19
第二節、 研究對象與樣本收集 .......................................................... 21
第三節、 樣本檢測 ............................................................................... 25
一、 尿中三聚氰胺檢測 .................................................................. 25
二、 尿中NAG 檢測 ....................................................................... 29
三、 尿中β2-microglobulin 檢測 .................................................... 32
四、 尿中creatinin 檢測 .................................................................. 33
第四章 研究結果 ...................................................................................... 38
第一節、 受試者基本資料分析 .......................................................... 38
第二節、 實驗結果 ............................................................................... 39
一、 β2-microglobulin 分析結果 ................................................... 39
二、 Creatinine 分析結果 .............................................................. 39
三、 Melamine 分析結果 ............................................................... 41
四、 NAG 分析結果 ....................................................................... 43
五、 父親Melamine 分析結果 ..................................................... 45
六、 父親NAG 分析結果 .............................................................. 46
七、 父親Creatinine 分析結果 ...................................................... 47
八、 母親Melamine 分析結果 ...................................................... 47
九、 母親NAG 分析結果 .............................................................. 48
十、 母親Creatinine 分析結果 ...................................................... 49
十一、 受試學童的尿中melamine 濃度與 NAG 相關性 ........... 50
十二、 父母親的melamine 與 NAG 相關性 .............................. 51
十三、 父母親與受試兒童melamine 濃度的相關性 .................. 52
第五章 討論與結論 ............................................................................... 63
第一節、 討論 ............................................................................... 63
第二節、 研究限制 ............................................................................... 67
第六章 結論 ............................................................................... 68
參考文獻 ............................................................................... 69

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